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Evaluation of Transient Elastography, Acoustic Radiation Force Impulse Imaging (ARFI), and Enhanced Liver Function (ELF) Score for Detection of Fibrosis in Morbidly Obese Patients
BACKGROUND: Liver fibrosis induced by non-alcoholic fatty liver disease causes peri-interventional complications in morbidly obese patients. We determined the performance of transient elastography (TE), acoustic radiation force impulse (ARFI) imaging, and enhanced liver fibrosis (ELF) score for fibr...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631322/ https://www.ncbi.nlm.nih.gov/pubmed/26528818 http://dx.doi.org/10.1371/journal.pone.0141649 |
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author | Karlas, Thomas Dietrich, Arne Peter, Veronica Wittekind, Christian Lichtinghagen, Ralf Garnov, Nikita Linder, Nicolas Schaudinn, Alexander Busse, Harald Prettin, Christiane Keim, Volker Tröltzsch, Michael Schütz, Tatjana Wiegand, Johannes |
author_facet | Karlas, Thomas Dietrich, Arne Peter, Veronica Wittekind, Christian Lichtinghagen, Ralf Garnov, Nikita Linder, Nicolas Schaudinn, Alexander Busse, Harald Prettin, Christiane Keim, Volker Tröltzsch, Michael Schütz, Tatjana Wiegand, Johannes |
author_sort | Karlas, Thomas |
collection | PubMed |
description | BACKGROUND: Liver fibrosis induced by non-alcoholic fatty liver disease causes peri-interventional complications in morbidly obese patients. We determined the performance of transient elastography (TE), acoustic radiation force impulse (ARFI) imaging, and enhanced liver fibrosis (ELF) score for fibrosis detection in bariatric patients. PATIENTS AND METHODS: 41 patients (median BMI 47 kg/m(2)) underwent 14-day low-energy diets to improve conditions prior to bariatric surgery (day 0). TE (M and XL probe), ARFI, and ELF score were performed on days -15 and -1 and compared with intraoperative liver biopsies (NAS staging). RESULTS: Valid TE and ARFI results at day -15 and -1 were obtained in 49%/88% and 51%/90% of cases, respectively. High skin-to-liver-capsule distances correlated with invalid TE measurements. Fibrosis of liver biopsies was staged as F1 and F3 in n = 40 and n = 1 individuals. However, variations (median/range at d-15/-1) of TE (4.6/2.6–75 and 6.7/2.9–21.3 kPa) and ARFI (2.1/0.7–3.7 and 2.0/0.7–3.8 m/s) were high and associated with overestimation of fibrosis. The ELF score correctly classified 87.5% of patients. CONCLUSION: In bariatric patients, performance of TE and ARFI was poor and did not improve after weight loss. The ELF score correctly classified the majority of cases and should be further evaluated. |
format | Online Article Text |
id | pubmed-4631322 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-46313222015-11-13 Evaluation of Transient Elastography, Acoustic Radiation Force Impulse Imaging (ARFI), and Enhanced Liver Function (ELF) Score for Detection of Fibrosis in Morbidly Obese Patients Karlas, Thomas Dietrich, Arne Peter, Veronica Wittekind, Christian Lichtinghagen, Ralf Garnov, Nikita Linder, Nicolas Schaudinn, Alexander Busse, Harald Prettin, Christiane Keim, Volker Tröltzsch, Michael Schütz, Tatjana Wiegand, Johannes PLoS One Research Article BACKGROUND: Liver fibrosis induced by non-alcoholic fatty liver disease causes peri-interventional complications in morbidly obese patients. We determined the performance of transient elastography (TE), acoustic radiation force impulse (ARFI) imaging, and enhanced liver fibrosis (ELF) score for fibrosis detection in bariatric patients. PATIENTS AND METHODS: 41 patients (median BMI 47 kg/m(2)) underwent 14-day low-energy diets to improve conditions prior to bariatric surgery (day 0). TE (M and XL probe), ARFI, and ELF score were performed on days -15 and -1 and compared with intraoperative liver biopsies (NAS staging). RESULTS: Valid TE and ARFI results at day -15 and -1 were obtained in 49%/88% and 51%/90% of cases, respectively. High skin-to-liver-capsule distances correlated with invalid TE measurements. Fibrosis of liver biopsies was staged as F1 and F3 in n = 40 and n = 1 individuals. However, variations (median/range at d-15/-1) of TE (4.6/2.6–75 and 6.7/2.9–21.3 kPa) and ARFI (2.1/0.7–3.7 and 2.0/0.7–3.8 m/s) were high and associated with overestimation of fibrosis. The ELF score correctly classified 87.5% of patients. CONCLUSION: In bariatric patients, performance of TE and ARFI was poor and did not improve after weight loss. The ELF score correctly classified the majority of cases and should be further evaluated. Public Library of Science 2015-11-03 /pmc/articles/PMC4631322/ /pubmed/26528818 http://dx.doi.org/10.1371/journal.pone.0141649 Text en © 2015 Karlas et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Karlas, Thomas Dietrich, Arne Peter, Veronica Wittekind, Christian Lichtinghagen, Ralf Garnov, Nikita Linder, Nicolas Schaudinn, Alexander Busse, Harald Prettin, Christiane Keim, Volker Tröltzsch, Michael Schütz, Tatjana Wiegand, Johannes Evaluation of Transient Elastography, Acoustic Radiation Force Impulse Imaging (ARFI), and Enhanced Liver Function (ELF) Score for Detection of Fibrosis in Morbidly Obese Patients |
title | Evaluation of Transient Elastography, Acoustic Radiation Force Impulse Imaging (ARFI), and Enhanced Liver Function (ELF) Score for Detection of Fibrosis in Morbidly Obese Patients |
title_full | Evaluation of Transient Elastography, Acoustic Radiation Force Impulse Imaging (ARFI), and Enhanced Liver Function (ELF) Score for Detection of Fibrosis in Morbidly Obese Patients |
title_fullStr | Evaluation of Transient Elastography, Acoustic Radiation Force Impulse Imaging (ARFI), and Enhanced Liver Function (ELF) Score for Detection of Fibrosis in Morbidly Obese Patients |
title_full_unstemmed | Evaluation of Transient Elastography, Acoustic Radiation Force Impulse Imaging (ARFI), and Enhanced Liver Function (ELF) Score for Detection of Fibrosis in Morbidly Obese Patients |
title_short | Evaluation of Transient Elastography, Acoustic Radiation Force Impulse Imaging (ARFI), and Enhanced Liver Function (ELF) Score for Detection of Fibrosis in Morbidly Obese Patients |
title_sort | evaluation of transient elastography, acoustic radiation force impulse imaging (arfi), and enhanced liver function (elf) score for detection of fibrosis in morbidly obese patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631322/ https://www.ncbi.nlm.nih.gov/pubmed/26528818 http://dx.doi.org/10.1371/journal.pone.0141649 |
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