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Transient Elastography Offers Liver Disease Screening Tool

New test is found superior to current biochemical tests to rule out fibrosis and cirrhosis

FRIDAY, Jan. 29 (HealthDay News) -- Transient elastography offers a new noninvasive screening test to detect or rule out significant fibrosis and early cirrhosis in patients with nonalcoholic fatty liver disease (NAFLD), according to a study in the February issue of Hepatology.

Vincent Wai-Sun Wong, M.D., of the Chinese University of Hong Kong, and colleagues took liver stiffness measurements in 246 patients with NAFLD using transient elastography and, within a week, performed percutaneous liver biopsy. The transient elastography and histological results were compared to evaluate transient elastography as a screening test.

Overall, the researchers judged transient elastography's ability to detect F2, F3, and F4 disease to be good, with areas under the receiver-operating characteristics curve (AUROCs) of 0.84, 0.93, and 0.95, respectively. These results were superior to the AUROCs for the biochemical tests in current use. The researchers successfully obtained measurements in more than 97 percent of non-obese patients and 75 percent of obese patients, and successful measurement of liver stiffness was not affected by hepatic steatosis or necroinflammation.

"In summary, Wong and colleagues have provided valuable data regarding the use of transient elastography in patients with NAFLD. Its strength appears to be for excluding advanced fibrosis and cirrhosis; however, there are a number of issues that need to be clarified before it is routinely used in the clinical setting," writes the author of an accompanying editorial.

One author reported advising, and being is a speaker for, Novartis and Bristol-Myers Squibb, as well as advising Pharmasset and Schering-Plough. Another author reported advising, and being a speaker for, AstraZeneca, GlaxoSmithKline and Roche.

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