The Use of M Probe and XL Probe in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD)
/ 0
- Details
- Category: Vol. 82, September 2014
- Hits: 688
The Use of M Probe and XL Probe in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD), DINA ATTIA
Abstract
The diagnosis of liver stiffness (LS) by transient elastog-raphy (TE) using the M and XL probes is influenced by the BMI. It is now recommended to use the XL probe for BMI >30kg/m2, however, no studies were performed to evaluate this recommendation. In this study, we evaluated the diagnostic performance of TE using the M and XL probes according to the BMI stratification in comparison to the liver biopsy in overweight and obese patients with NAFLD and NASH.
Methods: A total of 67 patients with NAFLD and NASH with body mass index (BMI) >24kg/m2 were consecutively enrolled in this study. All patients received TE and liver biopsy at the same day. Patients were stratified according to their BMI; <30kg/m2 underwent LS measurement using M probe and >30kg/m2 were measured using the XL probe.
Results: A reliable LS using M probe was detected in 100% of patients while LS measurement failed in one patient using XL probe with BMI=34kg/m2, grade 2 steatosis. A strong correlation was found between M probe and XL probes and histological liver fibrosis (p<0.001 and p<0.001, respec-tively) as well as NAFLD fibrosis score (p=0.004, p<0.001, respectively), FIB-4 score (p=0.001, p=0.004, respectively) and APRI score (p<0.001, p<0.012, respectively). Similarly, a significant correlation was detected with the grade of steatosis (p=0.029 and p=0.048, respectively. No correlation was detected with NASH or BMI. The area under the receiver operating curves of M and XL probe for F4 and F3 were 0.94 and 0.97, 0.95 and 0.98, respectively. The discordance between M and XL probe and liver histology was shown in the lower stages of liver fibrosis and higher grades of liver steatosis.
Conclusion: Stratification of patients with NAFLD/NASH according to their BMI results in excellent performance of the LS using the M and XL probe for advanced fibrosis and liver cirrhosis. LS using TE is the best non-invasive predictor in this group of patients.