Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates
| العنوان: | Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates |
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| المؤلفون: | Philippe Garteiser, Pauline Jouet, Marco Dioguardi Burgio, Bernard E. Van Beers, Pierre Bedossa, Daniela Calabrese, Séverine Ledoux, Laurent Castera, Muriel Coupaye, Marina Esposito-Farèse, Sabrina Doblas, Simon Msika |
| المصدر: | JHEP Reports JHEP Reports, Vol 3, Iss 6, Pp 100381-(2021) |
| بيانات النشر: | Elsevier, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, NAFLD, non-alcoholic fatty liver disease, bariatric surgery, NASH, non-alcoholic steatohepatitis, LSM, liver stiffness measurement, RC799-869, NAFLD, Nonalcoholic fatty liver disease, Non-invasive diagnosis, Internal Medicine, steatosis, AUROC, area under the receiver operating characteristic curve, Immunology and Allergy, Medicine, ST, SteatoTest, Grading (tumors), NAS, NAFLD activity score, Se, sensitivity, Hepatology, medicine.diagnostic_test, business.industry, Fatty liver, Gastroenterology, NASH, Diseases of the digestive system. Gastroenterology, medicine.disease, MRI-PDFF, MRI-proton density fat fraction, transient elastography, CAP, PPV, positive predictive value, Surgery, TE, transient elastography, FLIP, fatty liver inhibition of progression, HSI, hepatic steatosis index, NPV, negative predictive value, Liver biopsy, Sp, specificity, Steatosis, Steatohepatitis, CAP, controlled attenuation parameter, business, Transient elastography, Body mass index, MRI-PDFF, FLI, fatty liver index, Research Article |
| الوصف: | Background & Aims Tools for the non-invasive diagnosis of non-alcoholic steatohepatitis (NASH) in morbidly obese patients with suspected non-alcoholic fatty liver disease (NAFLD) are an unmet clinical need. We prospectively compared the performance of transient elastography, MRI, and 3 serum scores for the diagnosis of NAFLD, grading of steatosis and detection of NASH in bariatric surgery candidates. Methods Of 186 patients screened, 152 underwent liver biopsy, which was used as a reference for NAFLD (steatosis [S]>5%), steatosis grading and NASH diagnosis. Biopsies were read by a single expert pathologist. MRI-based proton density fat fraction (MRI-PDFF) was measured in an open-bore, vertical field 1.0T scanner and controlled attenuation parameter (CAP) was measured by transient elastography, using the XL probe. Serum scores (SteatoTest, hepatic steatosis index and fatty liver index) were also calculated. Results The applicability of MRI was better than that of FibroScan (98% vs. 79%; p 5%, S>33%, S>66% and NASH, respectively. Transient elastography had an AUROC of 0.80 for significant fibrosis (F0-F1 vs. F2-F3). MRI-PDFF had AUROCs of 0.97, 0.95, 0.92 and 0.84 for S>5%, S>33%, S>66% and NASH, respectively. When compared head-to-head in the 97 patients with all valid tests available, MRI-PDFF outperformed CAP for grading steatosis (S>33%, AUROC 0.97 vs. 0.78; p 66%, AUROC 0.93 vs. 0.75; p = 0.0015) and diagnosing NASH (AUROC 0.82 vs. 0.68; p = 0.0056). When compared in “intention to diagnose” analysis, MRI-PDFF outperformed CAP, hepatic steatosis index and fatty liver index for grading steatosis (S>5%, S>33% and S>66%). Conclusion MRI-PDFF outperforms CAP for diagnosing NAFLD, grading steatosis and excluding NASH in morbidly obese patients undergoing bariatric surgery. Lay summary Non-invasive tests for detecting fatty liver and steatohepatitis, the active form of the disease, have not been well studied in obese patients who are candidates for bariatric surgery. The most popular tests for this purpose are Fibroscan, which can be used to measure the controlled attenuation parameter (CAP), and magnetic resonance imaging, which can be used to measure the proton density fat fraction (MRI-PDFF). We found that, when taking liver biopsy as a reference, MRI-PDFF performed better than CAP for detecting and grading fatty liver as well as excluding steatohepatitis in morbidly obese patients undergoing bariatric surgery. Graphical abstract Highlights • NAFLD/NASH is common in morbidly obese patients undergoing bariatric surgery. • Non-invasive diagnosis of NAFLD/NASH is an unmet need in this population. • We compared MRI-PDFF, CAP and serum scores for grading steatosis and diagnosing NASH, using liver biopsy as a reference. • Applicability of magnetic resonance imaging was better than that of Fibroscan. • MRI-PDFF outperformed CAP for diagnosing and grading steatosis, as well as excluding NASH. |
| اللغة: | English |
| تدمد: | 2589-5559 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::aa1cbf2a3776a631ccda6d1dc1a90b42Test http://europepmc.org/articles/PMC8578045Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....aa1cbf2a3776a631ccda6d1dc1a90b42 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 25895559 |
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