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The use of transient elastography in the management of chronic hepatitis B

There has been increasing interest in noninvasive methods of assessing liver fibrosis over the last decade. The use of transient elastography in measuring liver stiffness has become the forefront of a wide range of noninvasive tools. Most of the other methods are based on measurements of biomarkers...

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Autores principales: Fung, James, Lai, Ching-Lung, Seto, Wai-Kay, Yuen, Man-Fung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer-Verlag 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215876/
https://www.ncbi.nlm.nih.gov/pubmed/21695588
http://dx.doi.org/10.1007/s12072-011-9288-5
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author Fung, James
Lai, Ching-Lung
Seto, Wai-Kay
Yuen, Man-Fung
author_facet Fung, James
Lai, Ching-Lung
Seto, Wai-Kay
Yuen, Man-Fung
author_sort Fung, James
collection PubMed
description There has been increasing interest in noninvasive methods of assessing liver fibrosis over the last decade. The use of transient elastography in measuring liver stiffness has become the forefront of a wide range of noninvasive tools. Most of the other methods are based on measurements of biomarkers associated with fibrosis. There are several reasons for its wide acceptance, including the ease of performing a scan, the short procedure time, the results being immediately available on completion of the examination, and its reproducibility. For chronic hepatitis B (CHB), the cut-off values for F3 and F4 fibrosis range between 7.5–12.0 and 11.0–13.4 kPa, respectively, although the cut-offs may be slightly lower in those with normal ALT. In addition to measuring liver fibrosis, recent studies have demonstrated several other roles for transient elastography, including selecting patients who will benefit from antiviral therapy, monitoring response to antiviral therapy, and predicting long-term outcomes. However, there are limitations associated with transient elastography, including the confounding effects of inflammatory activity, and to a lesser extent, steatosis, on liver stiffness. There is also reduced accuracy observed in lower fibrosis stages (F0–F2). Furthermore, the incidences of failed and unreliable scan have been reported to be ~ 3 and 16%, respectively. Although liver biopsy can be avoided in an estimated 50–60% using transient elastography, in situations where liver stiffness measurement is nondiagnostic or inconsistent with the clinical picture, a biopsy is still recommended. Further studies are needed to consolidate the role of transient elastography in the management of CHB, and for incorporation of this method into current treatment guidelines.
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spelling pubmed-32158762011-12-09 The use of transient elastography in the management of chronic hepatitis B Fung, James Lai, Ching-Lung Seto, Wai-Kay Yuen, Man-Fung Hepatol Int Review Article There has been increasing interest in noninvasive methods of assessing liver fibrosis over the last decade. The use of transient elastography in measuring liver stiffness has become the forefront of a wide range of noninvasive tools. Most of the other methods are based on measurements of biomarkers associated with fibrosis. There are several reasons for its wide acceptance, including the ease of performing a scan, the short procedure time, the results being immediately available on completion of the examination, and its reproducibility. For chronic hepatitis B (CHB), the cut-off values for F3 and F4 fibrosis range between 7.5–12.0 and 11.0–13.4 kPa, respectively, although the cut-offs may be slightly lower in those with normal ALT. In addition to measuring liver fibrosis, recent studies have demonstrated several other roles for transient elastography, including selecting patients who will benefit from antiviral therapy, monitoring response to antiviral therapy, and predicting long-term outcomes. However, there are limitations associated with transient elastography, including the confounding effects of inflammatory activity, and to a lesser extent, steatosis, on liver stiffness. There is also reduced accuracy observed in lower fibrosis stages (F0–F2). Furthermore, the incidences of failed and unreliable scan have been reported to be ~ 3 and 16%, respectively. Although liver biopsy can be avoided in an estimated 50–60% using transient elastography, in situations where liver stiffness measurement is nondiagnostic or inconsistent with the clinical picture, a biopsy is still recommended. Further studies are needed to consolidate the role of transient elastography in the management of CHB, and for incorporation of this method into current treatment guidelines. Springer-Verlag 2011-06-22 /pmc/articles/PMC3215876/ /pubmed/21695588 http://dx.doi.org/10.1007/s12072-011-9288-5 Text en © The Author(s) 2011 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Review Article
Fung, James
Lai, Ching-Lung
Seto, Wai-Kay
Yuen, Man-Fung
The use of transient elastography in the management of chronic hepatitis B
title The use of transient elastography in the management of chronic hepatitis B
title_full The use of transient elastography in the management of chronic hepatitis B
title_fullStr The use of transient elastography in the management of chronic hepatitis B
title_full_unstemmed The use of transient elastography in the management of chronic hepatitis B
title_short The use of transient elastography in the management of chronic hepatitis B
title_sort use of transient elastography in the management of chronic hepatitis b
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215876/
https://www.ncbi.nlm.nih.gov/pubmed/21695588
http://dx.doi.org/10.1007/s12072-011-9288-5
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