The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Victor De Ledinghen - One of the best experts on this subject based on the ideXlab platform.
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liver stiffness in nonalcoholic fatty liver disease a comparison of supersonic shear imaging FibroScan and arfi with liver biopsy
Hepatology, 2016Co-Authors: Christophe Cassinotto, Victor De Ledinghen, Jerome Boursier, Jeanbaptiste Hiriart, Brigitte Le Bail, S Michalak, J Lebigot, Bruno Lapuyade, Paul Cales, V CartierAbstract:Nonalcoholic fatty liver disease (NAFLD) has become a major public health issue. The goal of this study was to assess the clinical use of liver stiffness measurement (LSM) evaluated by supersonic shear imaging (SSI), FibroScan, and acoustic radiation force impulse (ARFI) in a cohort of NAFLD patients who underwent liver biopsy. A total of 291 NAFLD patients were prospectively enrolled from November 2011 to February 2015 at 2 French university hospitals. LSM was assessed by SSI, FibroScan (M probe), and ARFI within two weeks prior to liver biopsy. Calculations of the area under the receiver operating curve (AUROC) were performed and compared for the staging of liver fibrosis. AUROC for SSI, FibroScan, and ARFI were 0.86, 0.82, and 0.77 for diagnoses of ≥F2; 0.89, 0.86, and 0.84 for ≥F3; and 0.88, 0.87, and 0.84 for F4, respectively. SSI had a higher accuracy than ARFI for diagnoses of significant fibrosis (≥F2) (P = 0.004). Clinical factors related to obesity such as body mass index ≥ 30 kg/m2, waist circumference ≥102 cm or increased parietal wall thickness were associated with LSM failures when using SSI or FibroScan and with unreliable results when using ARFI. In univariate analysis, FibroScan values were slightly correlated with NAFLD activity score and steatosis (R = 0.28 and 0.22, respectively), whereas SSI and ARFI were not; however, these components of NAFLD did not affect LSM results in multivariate analysis. The cutoff values for SSI and FibroScan for staging fibrosis with a sensitivity ≥90% were very close: 6.3/6.2 kPa for ≥F2, 8.3/8.2 kPa for ≥F3, and 10.5/9.5 kPa for F4. Conclusion: Although obesity is associated with an increase in LSM failure, the studied techniques and especially SSI provide high value for the diagnosis of liver fibrosis in NAFLD patients. (Hepatology 2016;63:1817-1827)
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liver fibrosis noninvasive assessment with acoustic radiation force impulse elastography comparison with FibroScan m and xl probes and fibrotest in patients with chronic liver disease
Radiology, 2013Co-Authors: Christophe Cassinotto, Julien Vergniol, Brigitte Le Bail, J Foucher, Bruno Lapuyade, Delphine Gaye, Faiza Chermak, Ania Aitali, Claire Bailacqauder, Victor De LedinghenAbstract:We found that acoustic radiation force impulse elastography was a reliable diagnostic tool in nonobese patients and that failures of measurement with this technique are rare; its diagnostic performance was not significantly different from that of FibroScan M and XL probes in the diagnosis of cirrhosis or severe fibrosis.
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diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement comparison between m and xl probe of FibroScan
Journal of Hepatology, 2012Co-Authors: Victor De Ledinghen, Julien Vergniol, Brigitte Le Bail, J Foucher, Wassil Merrouche, Faiza Chermak, Grace Laihung Wong, Vincent Waisun Wong, Paul Cheunglung Choi, Henry Likyuen ChanAbstract:Background & Aims Unreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30kg/m 2 . A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of FibroScan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients. Methods Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1week before liver biopsy using both M and XL probes of FibroScan®. Results A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50years and BMI >30kg/m 2 . By univariate analysis, only BMI >30kg/m 2 was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis. Conclusions Liver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.
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relative performances of fibrotest FibroScan and biopsy for the assessment of the stage of liver fibrosis in patients with chronic hepatitis c a step toward the truth in the absence of a gold standard
Journal of Hepatology, 2012Co-Authors: Thierry Poynard, Victor De Ledinghen, Julien Vergniol, Jeanpierre Zarski, Carol Stanciu, Mona Munteanu, Anca Trifan, Gilles Le Naour, Jean Vaillant, Vlad RatziuAbstract:Background & Aims Liver fibrosis stage is traditionally assessed with biopsy, an imperfect gold standard. Two widely used techniques, FibroTest®, and liver stiffness measurement (LSM) using FibroScan® have been validated using biopsy, and therefore the true performances of these estimates are still unknown in the absence of a perfect reference. The aim was to assess the relative accuracy of FibroTest, LSM, and biopsy using methods without gold standard in patients with chronic hepatitis C (CHC) and controls. Methods A total of 1289 patients with CHC and 604 healthy volunteers, with assessment of fibrosis stage by the three techniques, and alanine aminotransferase (ALT) taken as a control test, were analyzed by latent class method with random effects. In the volunteers, the false positive risk of biopsy was obtained from a large surgical sample of four normal livers. Results The latent class model with random effects permitted to conciliate the observed data and estimates of test performances. For advanced fibrosis, the specificity/sensitivity was for FibroTest 0.93/0.70, LSM 0.96/0.45, ALT 0.79/0.78 and biopsy 0.67/0.63, and for cirrhosis FibroTest 0.87/0.41, LSM 0.93/0.39, ALT 0.78/0.08 and biopsy 0.95/0.51. The analysis of the discordances between pairs suggested that the variability of the model was mainly related to the discordances between biopsy and LSM (residuals>10; p Conclusions A method without the use of a gold standard confirmed the accuracy of FibroTest and FibroScan for the diagnosis of advanced fibrosis and cirrhosis in patients with chronic hepatitis C. The variability of the model was mostly due to the discordances between FibroScan and biopsy.
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a new combination of blood test and FibroScan for accurate non invasive diagnosis of liver fibrosis stages in chronic hepatitis c
The American Journal of Gastroenterology, 2011Co-Authors: Jerome Boursier, Victor De Ledinghen, Sandrine Bertrais, Jeanpierre Zarski, Mariechristine Rousselet, Nathalie Sturm, J Foucher, Vincent Leroy, I Fouchardhubert, J Foucher, Yves GalloisAbstract:A New Combination of Blood Test and FibroScan for Accurate Non-Invasive Diagnosis of Liver Fibrosis Stages in Chronic Hepatitis C
J Foucher - One of the best experts on this subject based on the ideXlab platform.
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non invasive assessment of liver fibrosis with impulse elastography comparison of supersonic shear imaging with arfi and FibroScan
Journal of Hepatology, 2014Co-Authors: Christophe Cassinotto, Julien Vergniol, Jeanbaptiste Hiriart, Brigitte Le Bail, Bruno Lapuyade, Amaury Mouries, Delphine Gaye, Claire Castain, Faiza Chermak, J FoucherAbstract:Background & Aims Non-invasive assessment of liver fibrosis by elastography is a rapidly developing field with frequent technological innovations. The aim of this study was to assess the diagnostic performances of Supersonic Shear Imaging (SSI) for the diagnosis of liver fibrosis in chronic liver disease. Methods A total of 349 consecutive patients with chronic liver diseases who underwent liver biopsy from November 2011 to October 2013 were prospectively enrolled. For each patient, liver stiffness was assessed by SSI, ARFI, FibroScan® (M probe for patients with BMI 2 , and XL probe for patients with BMI ⩾30kg/m 2 ), performed within two weeks of liver biopsy. Areas under the receiver operating curves (AUROCs) were performed and compared for each degree of liver fibrosis. Results SSI, FibroScan®, and ARFI correlated significantly with histological fibrosis score (r=0.79, p p p p =0.0016), and a higher accuracy than ARFI for the diagnosis of significant fibrosis (⩾F2) ( p =0.0003). No significant difference was observed for the diagnosis of mild fibrosis and cirrhosis. Conclusions SSI is an efficient method for the assessment of liver fibrosis in chronic liver diseases, comparing favourably to FibroScan® and ARFI.
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liver fibrosis noninvasive assessment with acoustic radiation force impulse elastography comparison with FibroScan m and xl probes and fibrotest in patients with chronic liver disease
Radiology, 2013Co-Authors: Christophe Cassinotto, Julien Vergniol, Brigitte Le Bail, J Foucher, Bruno Lapuyade, Delphine Gaye, Faiza Chermak, Ania Aitali, Claire Bailacqauder, Victor De LedinghenAbstract:We found that acoustic radiation force impulse elastography was a reliable diagnostic tool in nonobese patients and that failures of measurement with this technique are rare; its diagnostic performance was not significantly different from that of FibroScan M and XL probes in the diagnosis of cirrhosis or severe fibrosis.
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diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement comparison between m and xl probe of FibroScan
Journal of Hepatology, 2012Co-Authors: Victor De Ledinghen, Julien Vergniol, Brigitte Le Bail, J Foucher, Wassil Merrouche, Faiza Chermak, Grace Laihung Wong, Vincent Waisun Wong, Paul Cheunglung Choi, Henry Likyuen ChanAbstract:Background & Aims Unreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30kg/m 2 . A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of FibroScan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients. Methods Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1week before liver biopsy using both M and XL probes of FibroScan®. Results A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50years and BMI >30kg/m 2 . By univariate analysis, only BMI >30kg/m 2 was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis. Conclusions Liver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.
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a new combination of blood test and FibroScan for accurate non invasive diagnosis of liver fibrosis stages in chronic hepatitis c
The American Journal of Gastroenterology, 2011Co-Authors: Jerome Boursier, Victor De Ledinghen, Sandrine Bertrais, Jeanpierre Zarski, Mariechristine Rousselet, Nathalie Sturm, J Foucher, Vincent Leroy, I Fouchardhubert, J Foucher, Yves GalloisAbstract:A New Combination of Blood Test and FibroScan for Accurate Non-Invasive Diagnosis of Liver Fibrosis Stages in Chronic Hepatitis C
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989 new FibroScan probe for obese patients a pilot study of feasibility and performances in patients with bmi 30 kg m2
Journal of Hepatology, 2009Co-Authors: Victor De Ledinghen, Julien Vergniol, Celine Fournier, Veronique Miette, J Foucher, Wassil Merrouche, V Rigalleau, Laurent SandrinAbstract:Liver stiffness measurement (LSM) failure rate ranges between 2 and 10% when using FibroScan® and is generally due to obese patients. The aim of this prospective study was to evaluate a new probe for the FibroScan® designed to overcome this limitations in terms of feasibility compared to the M (standard) probe.100 patients with a BMI 30 kg/m2 were recruited (27 men, mean age 52 years, mean BMI 41 (30−64) kg/m2. LSM was attempted with the M (central US frequency: 5MHz, diameter: 7mm, measurement depths: 25−65mm below the skin surface) and XL (2.5MHz, 10mm, 35−75mm) probes using an ultrasound imaging system to optimize the measurement point.The feasibility of LSM with both probes is presented in Table 1 (Fisher’s exact test, Wilcoxon signed rank test). LSM was significantly (p< 0.05) correlated with platelets (Spearman: −0.24), phosphatase alkaline (0.25) and glycemia (0.45) but not to prothrombin time, total bilirubin, GGT or transaminases. It was significantly correlated with non invasive markers: FIB-4 (0.26), Forns (0.27) and Virahep-C (0.30). Due to the presence of non hepatic tissue in the volume explored with the M probe in overweighed patients, LSM was lower with XL probe than M Probe.
Brigitte Le Bail - One of the best experts on this subject based on the ideXlab platform.
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diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non alcoholic fatty liver disease
Journal of Hepatology, 2016Co-Authors: Jerome Boursier, Julien Vergniol, Anne Guillet, Jeanbaptiste Hiriart, Adrien Lannes, Brigitte Le Bail, S Michalak, Faiza Chermak, Sandrine Bertrais, Faiza Chermak, Jack FoucherAbstract:Background & Aims NAFLD is highly prevalent but only a small subset of patients develop advanced liver fibrosis with impaired liver-related prognosis. We aimed to compare blood fibrosis tests and liver stiffness measurement (LSM) by FibroScan for the diagnosis of liver fibrosis and the evaluation of prognosis in NAFLD. Methods Diagnostic accuracy was evaluated in a cross-sectional study including 452 NAFLD patients with liver biopsy (NASH-CRN fibrosis stage), LSM, and eight blood fibrosis tests (BARD, NAFLD fibrosis score, FibroMeter NAFLD , aspartate aminotransferase to platelet ratio index (APRI), FIB4, FibroTest, Hepascore, FibroMeter V2G ). Prognostic accuracy was evaluated in a longitudinal study including 360 NAFLD patients. Results LSM and FibroMeter V2G were the two best-performing tests in the cross-sectional study: AUROCs for advanced fibrosis (F3/4) were, respectively, 0.831±0.019 and 0.817±0.020 ( p ⩽0.041 vs. other tests); rates of patients with ⩾90% negative/positive predictive values for F3/4 were 56.4% and 46.7% ( p vs. other tests); Obuchowski indexes were 0.834±0.014 and 0.798±0.016 ( p ⩽0.036 vs. other tests). Two fibrosis classifications were developed to precisely estimate the histological fibrosis stage from LSM or FibroMeter V2G results without liver biopsy (diagnostic accuracy, respectively: 80.8% vs. 77.4%, p =0.190). Kaplan-Meier curves in the longitudinal study showed that both classifications categorised NAFLD patients into subgroups with significantly different prognoses ( p Conclusions LSM and FibroMeter V2G were the most accurate of nine evaluated tests for the non-invasive diagnosis of liver fibrosis in NAFLD. LSM and FibroMeter V2G fibrosis classifications help physicians estimate both fibrosis stage and patient prognosis in clinical practice. Lay summary The amount of liver fibrosis is the main determinant of the liver-related prognosis in patients with non-alcoholic fatty liver disease (NAFLD). We evaluated eight blood tests and FibroScan in a cross-sectional diagnostic study and found that FibroScan and the blood test FibroMeter V2G were the two most accurate tests for the non-invasive evaluation of liver fibrosis in NAFLD. A longitudinal prognostic study showed these two tests initially developed for the diagnosis are also prognostic markers as they allow for the stratification of NAFLD patients in several subgroups with significantly different prognosis.
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liver stiffness in nonalcoholic fatty liver disease a comparison of supersonic shear imaging FibroScan and arfi with liver biopsy
Hepatology, 2016Co-Authors: Christophe Cassinotto, Victor De Ledinghen, Jerome Boursier, Jeanbaptiste Hiriart, Brigitte Le Bail, S Michalak, J Lebigot, Bruno Lapuyade, Paul Cales, V CartierAbstract:Nonalcoholic fatty liver disease (NAFLD) has become a major public health issue. The goal of this study was to assess the clinical use of liver stiffness measurement (LSM) evaluated by supersonic shear imaging (SSI), FibroScan, and acoustic radiation force impulse (ARFI) in a cohort of NAFLD patients who underwent liver biopsy. A total of 291 NAFLD patients were prospectively enrolled from November 2011 to February 2015 at 2 French university hospitals. LSM was assessed by SSI, FibroScan (M probe), and ARFI within two weeks prior to liver biopsy. Calculations of the area under the receiver operating curve (AUROC) were performed and compared for the staging of liver fibrosis. AUROC for SSI, FibroScan, and ARFI were 0.86, 0.82, and 0.77 for diagnoses of ≥F2; 0.89, 0.86, and 0.84 for ≥F3; and 0.88, 0.87, and 0.84 for F4, respectively. SSI had a higher accuracy than ARFI for diagnoses of significant fibrosis (≥F2) (P = 0.004). Clinical factors related to obesity such as body mass index ≥ 30 kg/m2, waist circumference ≥102 cm or increased parietal wall thickness were associated with LSM failures when using SSI or FibroScan and with unreliable results when using ARFI. In univariate analysis, FibroScan values were slightly correlated with NAFLD activity score and steatosis (R = 0.28 and 0.22, respectively), whereas SSI and ARFI were not; however, these components of NAFLD did not affect LSM results in multivariate analysis. The cutoff values for SSI and FibroScan for staging fibrosis with a sensitivity ≥90% were very close: 6.3/6.2 kPa for ≥F2, 8.3/8.2 kPa for ≥F3, and 10.5/9.5 kPa for F4. Conclusion: Although obesity is associated with an increase in LSM failure, the studied techniques and especially SSI provide high value for the diagnosis of liver fibrosis in NAFLD patients. (Hepatology 2016;63:1817-1827)
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non invasive assessment of liver fibrosis with impulse elastography comparison of supersonic shear imaging with arfi and FibroScan
Journal of Hepatology, 2014Co-Authors: Christophe Cassinotto, Julien Vergniol, Jeanbaptiste Hiriart, Brigitte Le Bail, Bruno Lapuyade, Amaury Mouries, Delphine Gaye, Claire Castain, Faiza Chermak, J FoucherAbstract:Background & Aims Non-invasive assessment of liver fibrosis by elastography is a rapidly developing field with frequent technological innovations. The aim of this study was to assess the diagnostic performances of Supersonic Shear Imaging (SSI) for the diagnosis of liver fibrosis in chronic liver disease. Methods A total of 349 consecutive patients with chronic liver diseases who underwent liver biopsy from November 2011 to October 2013 were prospectively enrolled. For each patient, liver stiffness was assessed by SSI, ARFI, FibroScan® (M probe for patients with BMI 2 , and XL probe for patients with BMI ⩾30kg/m 2 ), performed within two weeks of liver biopsy. Areas under the receiver operating curves (AUROCs) were performed and compared for each degree of liver fibrosis. Results SSI, FibroScan®, and ARFI correlated significantly with histological fibrosis score (r=0.79, p p p p =0.0016), and a higher accuracy than ARFI for the diagnosis of significant fibrosis (⩾F2) ( p =0.0003). No significant difference was observed for the diagnosis of mild fibrosis and cirrhosis. Conclusions SSI is an efficient method for the assessment of liver fibrosis in chronic liver diseases, comparing favourably to FibroScan® and ARFI.
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liver fibrosis noninvasive assessment with acoustic radiation force impulse elastography comparison with FibroScan m and xl probes and fibrotest in patients with chronic liver disease
Radiology, 2013Co-Authors: Christophe Cassinotto, Julien Vergniol, Brigitte Le Bail, J Foucher, Bruno Lapuyade, Delphine Gaye, Faiza Chermak, Ania Aitali, Claire Bailacqauder, Victor De LedinghenAbstract:We found that acoustic radiation force impulse elastography was a reliable diagnostic tool in nonobese patients and that failures of measurement with this technique are rare; its diagnostic performance was not significantly different from that of FibroScan M and XL probes in the diagnosis of cirrhosis or severe fibrosis.
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diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement comparison between m and xl probe of FibroScan
Journal of Hepatology, 2012Co-Authors: Victor De Ledinghen, Julien Vergniol, Brigitte Le Bail, J Foucher, Wassil Merrouche, Faiza Chermak, Grace Laihung Wong, Vincent Waisun Wong, Paul Cheunglung Choi, Henry Likyuen ChanAbstract:Background & Aims Unreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30kg/m 2 . A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of FibroScan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients. Methods Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1week before liver biopsy using both M and XL probes of FibroScan®. Results A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50years and BMI >30kg/m 2 . By univariate analysis, only BMI >30kg/m 2 was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis. Conclusions Liver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.
Julien Vergniol - One of the best experts on this subject based on the ideXlab platform.
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diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non alcoholic fatty liver disease
Journal of Hepatology, 2016Co-Authors: Jerome Boursier, Julien Vergniol, Anne Guillet, Jeanbaptiste Hiriart, Adrien Lannes, Brigitte Le Bail, S Michalak, Faiza Chermak, Sandrine Bertrais, Faiza Chermak, Jack FoucherAbstract:Background & Aims NAFLD is highly prevalent but only a small subset of patients develop advanced liver fibrosis with impaired liver-related prognosis. We aimed to compare blood fibrosis tests and liver stiffness measurement (LSM) by FibroScan for the diagnosis of liver fibrosis and the evaluation of prognosis in NAFLD. Methods Diagnostic accuracy was evaluated in a cross-sectional study including 452 NAFLD patients with liver biopsy (NASH-CRN fibrosis stage), LSM, and eight blood fibrosis tests (BARD, NAFLD fibrosis score, FibroMeter NAFLD , aspartate aminotransferase to platelet ratio index (APRI), FIB4, FibroTest, Hepascore, FibroMeter V2G ). Prognostic accuracy was evaluated in a longitudinal study including 360 NAFLD patients. Results LSM and FibroMeter V2G were the two best-performing tests in the cross-sectional study: AUROCs for advanced fibrosis (F3/4) were, respectively, 0.831±0.019 and 0.817±0.020 ( p ⩽0.041 vs. other tests); rates of patients with ⩾90% negative/positive predictive values for F3/4 were 56.4% and 46.7% ( p vs. other tests); Obuchowski indexes were 0.834±0.014 and 0.798±0.016 ( p ⩽0.036 vs. other tests). Two fibrosis classifications were developed to precisely estimate the histological fibrosis stage from LSM or FibroMeter V2G results without liver biopsy (diagnostic accuracy, respectively: 80.8% vs. 77.4%, p =0.190). Kaplan-Meier curves in the longitudinal study showed that both classifications categorised NAFLD patients into subgroups with significantly different prognoses ( p Conclusions LSM and FibroMeter V2G were the most accurate of nine evaluated tests for the non-invasive diagnosis of liver fibrosis in NAFLD. LSM and FibroMeter V2G fibrosis classifications help physicians estimate both fibrosis stage and patient prognosis in clinical practice. Lay summary The amount of liver fibrosis is the main determinant of the liver-related prognosis in patients with non-alcoholic fatty liver disease (NAFLD). We evaluated eight blood tests and FibroScan in a cross-sectional diagnostic study and found that FibroScan and the blood test FibroMeter V2G were the two most accurate tests for the non-invasive evaluation of liver fibrosis in NAFLD. A longitudinal prognostic study showed these two tests initially developed for the diagnosis are also prognostic markers as they allow for the stratification of NAFLD patients in several subgroups with significantly different prognosis.
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non invasive assessment of liver fibrosis with impulse elastography comparison of supersonic shear imaging with arfi and FibroScan
Journal of Hepatology, 2014Co-Authors: Christophe Cassinotto, Julien Vergniol, Jeanbaptiste Hiriart, Brigitte Le Bail, Bruno Lapuyade, Amaury Mouries, Delphine Gaye, Claire Castain, Faiza Chermak, J FoucherAbstract:Background & Aims Non-invasive assessment of liver fibrosis by elastography is a rapidly developing field with frequent technological innovations. The aim of this study was to assess the diagnostic performances of Supersonic Shear Imaging (SSI) for the diagnosis of liver fibrosis in chronic liver disease. Methods A total of 349 consecutive patients with chronic liver diseases who underwent liver biopsy from November 2011 to October 2013 were prospectively enrolled. For each patient, liver stiffness was assessed by SSI, ARFI, FibroScan® (M probe for patients with BMI 2 , and XL probe for patients with BMI ⩾30kg/m 2 ), performed within two weeks of liver biopsy. Areas under the receiver operating curves (AUROCs) were performed and compared for each degree of liver fibrosis. Results SSI, FibroScan®, and ARFI correlated significantly with histological fibrosis score (r=0.79, p p p p =0.0016), and a higher accuracy than ARFI for the diagnosis of significant fibrosis (⩾F2) ( p =0.0003). No significant difference was observed for the diagnosis of mild fibrosis and cirrhosis. Conclusions SSI is an efficient method for the assessment of liver fibrosis in chronic liver diseases, comparing favourably to FibroScan® and ARFI.
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liver fibrosis noninvasive assessment with acoustic radiation force impulse elastography comparison with FibroScan m and xl probes and fibrotest in patients with chronic liver disease
Radiology, 2013Co-Authors: Christophe Cassinotto, Julien Vergniol, Brigitte Le Bail, J Foucher, Bruno Lapuyade, Delphine Gaye, Faiza Chermak, Ania Aitali, Claire Bailacqauder, Victor De LedinghenAbstract:We found that acoustic radiation force impulse elastography was a reliable diagnostic tool in nonobese patients and that failures of measurement with this technique are rare; its diagnostic performance was not significantly different from that of FibroScan M and XL probes in the diagnosis of cirrhosis or severe fibrosis.
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diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement comparison between m and xl probe of FibroScan
Journal of Hepatology, 2012Co-Authors: Victor De Ledinghen, Julien Vergniol, Brigitte Le Bail, J Foucher, Wassil Merrouche, Faiza Chermak, Grace Laihung Wong, Vincent Waisun Wong, Paul Cheunglung Choi, Henry Likyuen ChanAbstract:Background & Aims Unreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30kg/m 2 . A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of FibroScan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients. Methods Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1week before liver biopsy using both M and XL probes of FibroScan®. Results A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50years and BMI >30kg/m 2 . By univariate analysis, only BMI >30kg/m 2 was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis. Conclusions Liver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.
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relative performances of fibrotest FibroScan and biopsy for the assessment of the stage of liver fibrosis in patients with chronic hepatitis c a step toward the truth in the absence of a gold standard
Journal of Hepatology, 2012Co-Authors: Thierry Poynard, Victor De Ledinghen, Julien Vergniol, Jeanpierre Zarski, Carol Stanciu, Mona Munteanu, Anca Trifan, Gilles Le Naour, Jean Vaillant, Vlad RatziuAbstract:Background & Aims Liver fibrosis stage is traditionally assessed with biopsy, an imperfect gold standard. Two widely used techniques, FibroTest®, and liver stiffness measurement (LSM) using FibroScan® have been validated using biopsy, and therefore the true performances of these estimates are still unknown in the absence of a perfect reference. The aim was to assess the relative accuracy of FibroTest, LSM, and biopsy using methods without gold standard in patients with chronic hepatitis C (CHC) and controls. Methods A total of 1289 patients with CHC and 604 healthy volunteers, with assessment of fibrosis stage by the three techniques, and alanine aminotransferase (ALT) taken as a control test, were analyzed by latent class method with random effects. In the volunteers, the false positive risk of biopsy was obtained from a large surgical sample of four normal livers. Results The latent class model with random effects permitted to conciliate the observed data and estimates of test performances. For advanced fibrosis, the specificity/sensitivity was for FibroTest 0.93/0.70, LSM 0.96/0.45, ALT 0.79/0.78 and biopsy 0.67/0.63, and for cirrhosis FibroTest 0.87/0.41, LSM 0.93/0.39, ALT 0.78/0.08 and biopsy 0.95/0.51. The analysis of the discordances between pairs suggested that the variability of the model was mainly related to the discordances between biopsy and LSM (residuals>10; p Conclusions A method without the use of a gold standard confirmed the accuracy of FibroTest and FibroScan for the diagnosis of advanced fibrosis and cirrhosis in patients with chronic hepatitis C. The variability of the model was mostly due to the discordances between FibroScan and biopsy.
Christophe Cassinotto - One of the best experts on this subject based on the ideXlab platform.
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liver stiffness in nonalcoholic fatty liver disease a comparison of supersonic shear imaging FibroScan and arfi with liver biopsy
Hepatology, 2016Co-Authors: Christophe Cassinotto, Victor De Ledinghen, Jerome Boursier, Jeanbaptiste Hiriart, Brigitte Le Bail, S Michalak, J Lebigot, Bruno Lapuyade, Paul Cales, V CartierAbstract:Nonalcoholic fatty liver disease (NAFLD) has become a major public health issue. The goal of this study was to assess the clinical use of liver stiffness measurement (LSM) evaluated by supersonic shear imaging (SSI), FibroScan, and acoustic radiation force impulse (ARFI) in a cohort of NAFLD patients who underwent liver biopsy. A total of 291 NAFLD patients were prospectively enrolled from November 2011 to February 2015 at 2 French university hospitals. LSM was assessed by SSI, FibroScan (M probe), and ARFI within two weeks prior to liver biopsy. Calculations of the area under the receiver operating curve (AUROC) were performed and compared for the staging of liver fibrosis. AUROC for SSI, FibroScan, and ARFI were 0.86, 0.82, and 0.77 for diagnoses of ≥F2; 0.89, 0.86, and 0.84 for ≥F3; and 0.88, 0.87, and 0.84 for F4, respectively. SSI had a higher accuracy than ARFI for diagnoses of significant fibrosis (≥F2) (P = 0.004). Clinical factors related to obesity such as body mass index ≥ 30 kg/m2, waist circumference ≥102 cm or increased parietal wall thickness were associated with LSM failures when using SSI or FibroScan and with unreliable results when using ARFI. In univariate analysis, FibroScan values were slightly correlated with NAFLD activity score and steatosis (R = 0.28 and 0.22, respectively), whereas SSI and ARFI were not; however, these components of NAFLD did not affect LSM results in multivariate analysis. The cutoff values for SSI and FibroScan for staging fibrosis with a sensitivity ≥90% were very close: 6.3/6.2 kPa for ≥F2, 8.3/8.2 kPa for ≥F3, and 10.5/9.5 kPa for F4. Conclusion: Although obesity is associated with an increase in LSM failure, the studied techniques and especially SSI provide high value for the diagnosis of liver fibrosis in NAFLD patients. (Hepatology 2016;63:1817-1827)
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non invasive assessment of liver fibrosis with impulse elastography comparison of supersonic shear imaging with arfi and FibroScan
Journal of Hepatology, 2014Co-Authors: Christophe Cassinotto, Julien Vergniol, Jeanbaptiste Hiriart, Brigitte Le Bail, Bruno Lapuyade, Amaury Mouries, Delphine Gaye, Claire Castain, Faiza Chermak, J FoucherAbstract:Background & Aims Non-invasive assessment of liver fibrosis by elastography is a rapidly developing field with frequent technological innovations. The aim of this study was to assess the diagnostic performances of Supersonic Shear Imaging (SSI) for the diagnosis of liver fibrosis in chronic liver disease. Methods A total of 349 consecutive patients with chronic liver diseases who underwent liver biopsy from November 2011 to October 2013 were prospectively enrolled. For each patient, liver stiffness was assessed by SSI, ARFI, FibroScan® (M probe for patients with BMI 2 , and XL probe for patients with BMI ⩾30kg/m 2 ), performed within two weeks of liver biopsy. Areas under the receiver operating curves (AUROCs) were performed and compared for each degree of liver fibrosis. Results SSI, FibroScan®, and ARFI correlated significantly with histological fibrosis score (r=0.79, p p p p =0.0016), and a higher accuracy than ARFI for the diagnosis of significant fibrosis (⩾F2) ( p =0.0003). No significant difference was observed for the diagnosis of mild fibrosis and cirrhosis. Conclusions SSI is an efficient method for the assessment of liver fibrosis in chronic liver diseases, comparing favourably to FibroScan® and ARFI.
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liver fibrosis noninvasive assessment with acoustic radiation force impulse elastography comparison with FibroScan m and xl probes and fibrotest in patients with chronic liver disease
Radiology, 2013Co-Authors: Christophe Cassinotto, Julien Vergniol, Brigitte Le Bail, J Foucher, Bruno Lapuyade, Delphine Gaye, Faiza Chermak, Ania Aitali, Claire Bailacqauder, Victor De LedinghenAbstract:We found that acoustic radiation force impulse elastography was a reliable diagnostic tool in nonobese patients and that failures of measurement with this technique are rare; its diagnostic performance was not significantly different from that of FibroScan M and XL probes in the diagnosis of cirrhosis or severe fibrosis.