Discordance in steatosis classification between liver biopsy and transient elastography for high controlled attenuation parameter (CAP) values
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Discordance in steatosis classification between liver biopsy and transient elastography for high controlled attenuation parameter (CAP) values. / Galaski, Johanna; Schulz, Lisa; Krause, Jenny; Lohse, Ansgar W.
in: Z GASTROENTEROL, Jahrgang 56, Nr. 1, 01.2018, S. 36-42.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Discordance in steatosis classification between liver biopsy and transient elastography for high controlled attenuation parameter (CAP) values
AU - Galaski, Johanna
AU - Schulz, Lisa
AU - Krause, Jenny
AU - Lohse, Ansgar W
N1 - © Georg Thieme Verlag KG Stuttgart · New York.
PY - 2018/1
Y1 - 2018/1
N2 - OBJECTIVE: The controlled attenuation parameter (CAP) measured by transient elastography allows for the noninvasive assessment of hepatic steatosis. However, discrepant results between CAP values and histological evaluation have been reported in particular with high CAP values. We therefore investigated the diagnostic validity of high CAP measurements.METHODS: Forty patients with liver disease and CAP measurements > 300 dB/m that underwent ultrasound-guided or minilaparoscopic liver biopsy were retrospectively enrolled. CAP values were compared with the respective histological and macroscopic evaluation and correlated with clinical parameters.RESULTS: CAP values > 300 dB/m had an 87.5 % specificity for detection of hepatic steatosis but failed to discriminate between steatosis grade S1 - S3. Discordant results, defined as a discrepancy of at least 2 steatosis grades between transient elastography and liver biopsy, were observed in 40 % of cases. The interquartile range (IQR) of CAP was confirmed as a predictor of discrepant findings. Macroscopic evaluation as part of minilaparoscopy detected hepatic steatosis in 74 % of patients with histological grade S2 - S3 in contrast to only 10 % classified as histological grade S0 - S1.CONCLUSION: High CAP measurements need to be interpreted with care and with regard to clinical parameters, in particular when high IQR values are registered.
AB - OBJECTIVE: The controlled attenuation parameter (CAP) measured by transient elastography allows for the noninvasive assessment of hepatic steatosis. However, discrepant results between CAP values and histological evaluation have been reported in particular with high CAP values. We therefore investigated the diagnostic validity of high CAP measurements.METHODS: Forty patients with liver disease and CAP measurements > 300 dB/m that underwent ultrasound-guided or minilaparoscopic liver biopsy were retrospectively enrolled. CAP values were compared with the respective histological and macroscopic evaluation and correlated with clinical parameters.RESULTS: CAP values > 300 dB/m had an 87.5 % specificity for detection of hepatic steatosis but failed to discriminate between steatosis grade S1 - S3. Discordant results, defined as a discrepancy of at least 2 steatosis grades between transient elastography and liver biopsy, were observed in 40 % of cases. The interquartile range (IQR) of CAP was confirmed as a predictor of discrepant findings. Macroscopic evaluation as part of minilaparoscopy detected hepatic steatosis in 74 % of patients with histological grade S2 - S3 in contrast to only 10 % classified as histological grade S0 - S1.CONCLUSION: High CAP measurements need to be interpreted with care and with regard to clinical parameters, in particular when high IQR values are registered.
KW - Journal Article
U2 - 10.1055/s-0043-123829
DO - 10.1055/s-0043-123829
M3 - SCORING: Journal article
C2 - 29316576
VL - 56
SP - 36
EP - 42
JO - Z GASTROENTEROL
JF - Z GASTROENTEROL
SN - 0044-2771
IS - 1
ER -