Mohammad Shadab Siddiqui1, Michael O Idowu2, Katharine Stromberg3, Adam Sima3, Emily Lee4, Samarth Patel1, Sophia Ghaus4, Carolyn Driscoll1, Richard K Sterling1, Binu John1, Chandra S Bhati5. 1. Division of Gastroenterology and Hepatology, Virginia Commonwealth University, Richmond, Virginia. 2. Department of Pathology, Virginia Commonwealth University, Richmond, Virginia. 3. Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia. 4. School of Medicine, Virginia Commonwealth University, Richmond, Virginia. 5. Division of Transplant Surgery, Virginia Commonwealth University, Richmond, Virginia. Electronic address: Chandra.bhati@vcuhealth.org.
Abstract
BACKGROUND & AIMS: Vibration-controlled transient elastography (VCTE) is a non-invasive tool for detecting hepatic steatosis and fibrosis in patients who have not received liver transplants. We aimed to evaluate the diagnostic performance of VCTE in detection of hepatic steatosis and fibrosis in patients who have undergone liver transplantation. METHODS: We performed a prospective study of 99 liver transplant recipients assessed by VCTE using a standard protocol. Controlled attenuation parameter cutoff values for pairwise steatosis grade and liver stiffness measurements (LSM) and cutoff values for pairwise fibrosis stage were determined using cross-validated area under the receiver operating characteristics (AUROC) curve analyses. We calculated sensitivity (fixed at 90%) and specificity (fixed at 90%) values. RESULTS: A controlled attenuation parameter cutoff value of 270 dB/m detected any hepatic steatosis with an AUROC of 0.88 (95% CI, 0.78-0.93). VCTE detected steatosis grades 2-3 vs 0-1 with an AUROC of 0.94 (95% CI, 0.89-0.99) and steatosis grade 3 vs 0-2 was similar and AUROC of 0.89 (95% CI, 0.83-0.96). When we used an LSM cutoff value of 10.5 kPa, VCTE identified patients with advanced fibrosis (fibrosis stages ≥ 3) with an AUROC of 0.94 (95% CI, 0.88-0.99). At fixed sensitivity, the cutoff LSM value of 10.5k Pa excluded advanced fibrosis with a negative predictive value of 0.99. At fixed specificity, the cutoff LSM value of 16.9 kPa detected advanced fibrosis with a sensitivity of 0.86, a positive predictive value (PPV) of 0.40, and a negative predictive value of 0.99. CONCLUSIONS: VCTE accurately detects hepatic steatosis and fibrosis in recipients of liver transplants. This non-invasive method might be used to identify patients in need of confirmatory liver biopsy analysis.
BACKGROUND & AIMS: Vibration-controlled transient elastography (VCTE) is a non-invasive tool for detecting hepatic steatosis and fibrosis in patients who have not received liver transplants. We aimed to evaluate the diagnostic performance of VCTE in detection of hepatic steatosis and fibrosis in patients who have undergone liver transplantation. METHODS: We performed a prospective study of 99 liver transplant recipients assessed by VCTE using a standard protocol. Controlled attenuation parameter cutoff values for pairwise steatosis grade and liver stiffness measurements (LSM) and cutoff values for pairwise fibrosis stage were determined using cross-validated area under the receiver operating characteristics (AUROC) curve analyses. We calculated sensitivity (fixed at 90%) and specificity (fixed at 90%) values. RESULTS: A controlled attenuation parameter cutoff value of 270 dB/m detected any hepatic steatosis with an AUROC of 0.88 (95% CI, 0.78-0.93). VCTE detected steatosis grades 2-3 vs 0-1 with an AUROC of 0.94 (95% CI, 0.89-0.99) and steatosis grade 3 vs 0-2 was similar and AUROC of 0.89 (95% CI, 0.83-0.96). When we used an LSM cutoff value of 10.5 kPa, VCTE identified patients with advanced fibrosis (fibrosis stages ≥ 3) with an AUROC of 0.94 (95% CI, 0.88-0.99). At fixed sensitivity, the cutoff LSM value of 10.5k Pa excluded advanced fibrosis with a negative predictive value of 0.99. At fixed specificity, the cutoff LSM value of 16.9 kPa detected advanced fibrosis with a sensitivity of 0.86, a positive predictive value (PPV) of 0.40, and a negative predictive value of 0.99. CONCLUSIONS: VCTE accurately detects hepatic steatosis and fibrosis in recipients of liver transplants. This non-invasive method might be used to identify patients in need of confirmatory liver biopsy analysis.
Authors: Chandra Bhati; Michael O Idowu; Arun J Sanyal; Maria Rivera; Carolyn Driscoll; Richard T Stravitz; Divyanshoo R Kohli; Scott Matherly; Puneet Puri; HoChong Gilles; Adrian Cotterell; Marlon Levy; Richard K Sterling; Velimir A Luketic; Hannah Lee; Amit Sharma; Mohammad Shadab Siddiqui Journal: Transplantation Date: 2017-08 Impact factor: 4.939
Authors: M Berenguer; L Ferrell; J Watson; M Prieto; M Kim; M Rayón; J Córdoba; A Herola; N Ascher; J Mir; J Berenguer; T L Wright Journal: J Hepatol Date: 2000-04 Impact factor: 25.083
Authors: Jun Chen; Meng Yin; Jayant A Talwalkar; Jennifer Oudry; Kevin J Glaser; Thomas C Smyrk; Véronique Miette; Laurent Sandrin; Richard L Ehman Journal: Radiology Date: 2016-11-18 Impact factor: 11.105
Authors: G Crespo; M Gambato; O Millán; G Casals; P Ruiz; M C Londoño; A Mira; X Forns; M Brunet; W Jiménez; M Navasa Journal: Transpl Infect Dis Date: 2016-05-30 Impact factor: 2.228
Authors: Mohammad Shadab Siddiqui; Anh T Bui; Taseen Syed; Michael Tseng; Ramzi Hassouneh; Chandra S Bhati Journal: Clin Gastroenterol Hepatol Date: 2022-02-15 Impact factor: 13.576
Authors: Alshaima Alhinai; Afsheen Qayyum-Khan; Xun Zhang; Patrick Samaha; Peter Metrakos; Marc Deschenes; Philip Wong; Peter Ghali; Tian-Yan Chen; Giada Sebastiani Journal: World J Hepatol Date: 2021-12-27
Authors: Mohammad S Siddiqui; Samarth Patel; Mikael Forsgren; Anh T Bui; Steve Shen; Taseen Syed; Sherry Boyett; Shanshan Chen; Arun J Sanyal; Susan Wolver; Danielle Kirkman; Francesco S Celi; Chandra S Bhati Journal: Liver Int Date: 2022-02-24 Impact factor: 8.754