Comparison of the liver stiffness measurement by transient elastography with the liver biopsy

AIM: To compare the liver stiffness (LS) measurement by transient elastography (TE) to the liver biopsy (LB)-considered the "gold standard" in the evaluation of patients with chronic hepatitis C. METHODS: During a period of 12 mo, we evaluated 199 consecutive patients with chronic hepatitis due to hepatitis C virus (HCV), in which LB and LS assessments (by means of TE) were performed during the same session. RESULTS: Out of 199 patients, a valid measurement of the LS could not be obtained in 8. The mean value of LS in the cohort of 191 valid measurements was 8.45 + 4.96 kPa, ranging from 2.3 to 38 kPa. The mean value of LS in patients with significant fibrosis at biopsy (161 patients with F ≥ 2 according to Metavir) was 9.02±5.15 kPa, significantly higher than in patients with no or mild fibrosis (30 patients with F < 2="" metavir):="" 5.39="" ±="" 1.81="" kpa="" (p="">< 0.0001).="" for="" a="" cut-off="" value="" of="" 6.8="" kpa,="" the="" ls="" had="" a="" ppv="" of="" 98%,="" a="" npv="" of="" 30.1%,="" a="" sensitivity="" of="" 59.6%="" and="" a="" specificity="" of="" 93.3%="" for="" the="" presence="" of="" significant="" fibrosis="" (at="" least="" f2="" metavir),="" with="" a="" diagnostic="" performance="" of="" 77.3%="" (auroc="" 0.773).="" using="" this="" cut-off="" value,="" we="" reached="" the="" best="" discrimination="" between="" absence="" of="" fibrosis/="" mild="" fibrosis="" (f="">< 2="" metavir)="" and="" the="" presence="" of="" moderate="" to="" severe="" fibrosis="" (f="" ≥="" 2="" metavir).="" conclusion:="" in="" patients="" with="" chronic="" hepatitis="" due="" to="" hcv,="" a="" cut-off="" value="" of="" 6.8="" kpa="" measured="" by="" te="" can="" differentiate="" between="" significant="" fibrosis="" and="" absent="" or="" mild="" fibrosis,="" with="" a="" ppv="" of="" 98%,="" a="" npv="" of="" 30.1%,="" a="" sensitivity="" of="" 59.6%,="" a="" specificity="" of="" 93.3%,="" and="" a="" diagnostic="" performance="" of="" 77.3%.="">