A Prospective Blinded Study of Endoscopic Ultrasound Elastography in Liver Disease: Towards a Virtual Biopsy.
- Author:
Allison R SCHULMAN
1
;
Ming V LIN
;
Anna RUTHERFORD
;
Walter W CHAN
;
Marvin RYOU
Author Information
- Publication Type:Original Article
- Keywords: Endosonography; Endoscopic ultrasound; Elasticity imaging techniques; Chronic liver disease; Advanced imaging
- MeSH: Adipose Tissue; Biopsy*; Elasticity Imaging Techniques*; Endosonography; Fatty Liver; Fibrosis; Humans; Image Enhancement; Liver Cirrhosis; Liver Diseases*; Liver*; Prospective Studies*; Ultrasonography*
- From:Clinical Endoscopy 2018;51(2):181-185
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Liver biopsy has traditionally been used for determining the degree of fibrosis, however there are several limitations. Endoscopic ultrasound (EUS) real-time elastography (RTE) is a novel technology that uses image enhancement to display differences in tissue compressibility. We sought to assess whether liver fibrosis index (LFI) can distinguish normal, fatty, and cirrhotic liver tissue. METHODS: A total of 50 patients undergoing EUS were prospectively enrolled. RTE of the liver was performed to synthesize the LFI in each patient. Univariate and multivariable analyses were performed. Chi-square and t-tests were performed for categorical and continuous variables, respectively. A p-value of <0.05 was considered significant. RESULTS: Abdominal imaging prior to endoscopic evaluation suggested normal tissue, fatty liver, and cirrhosis in 26, 16, and 8 patients, respectively. Patients with cirrhosis had significantly increased mean LFI compared to the fatty liver (3.2 vs. 1.7, p<0.001) and normal (3.2 vs. 0.8, p<0.001) groups. The fatty liver group showed significantly increased LFI compared to the normal group (3.8 vs. 1.4, p<0.001). Multivariable regression analysis suggested that LFI was an independent predictor of group features (p<0.001). CONCLUSIONS: LFI computed from RTE images significantly correlates with abdominal imaging and can distinguish normal, fatty, and cirrhotic-appearing livers; therefore, LFI may play an important role in patients with chronic liver disease.
