Transient elastography for the assessment of chronic liver disease: Ready for the clinic?

Table 1 Liver stiffness cut-off values for the diagnosis of cirrhosis according to the primary cause of liver disease

	Optimum cutoff (kPa)
	Hepatitis C(n = 298)	Hepatitis B(n = 122)	Alcohol or NASH (n = 122)
Sensitivity 95%	10.0	6.0	13.2
Max. sum of sensitivity and specificity	10.4	10.3	21.5
Best diagnostic accuracy	20.2	16.9	21.5
Specificity 95%	14.1	14.3	27.7

NASH: Non-alcoholic steatohepatitis. Data obtained from Ganne-Carrie et al 2006[17].

Table 2 Results of studies in which liver stiffness was compared with histological fibrosis stage (METAVIR system) to establish diagnostic accuracy and cut-off values

Author, yr	Patient group	Number ofsubjects	Cut-off forF ≥ 2 (kPa)	AUROCF ≥ 2	Cut-off forF = 4 (kPa)	AUROCF = 4
Fraquelli M et al 2007[24]	Mixed (HCV)	195 (155)	7.9 (72%; 84%)	0.86	11.9 (91%; 89%)	0.90
Ganne-Carrie N et al 2006[17]	Mixed (HCV)	1007 (298)			14.6 (79%; 95%)	0.92
De Ledinghen V et al 2006[23]	HCV/HIV co-infected	72	4.5 (93%; 17%)	0.72	11.8 (100%; 93%)	0.97
Gomez-Dominguez E et al 2006[22]	Mixed (HCV)	94 (62)	4 (94%; 33%)	0.74	16 (89%; 96%)	0.94
Carrion J et al 2006[21]	HCV post transplant	169	8.5 (90%; 81%)	0.90	12.5 (100%; 87%)	0.98
Corpechot C et al 2006[20]	PBC/PSC	101	7.3 (84%; 87%)	0.92	17.3 (93%; 95% )	0.96
Foucher J et al 2006[25]	Mixed	354	7.2 (64%; 85%)	0.80	17.6 (77%; 97%)	0.96
Castera L et al 2005[31]	HCV	183	7.1 (67%; 89%)	0.83	12.5 (87%; 91%)	0.95
Ziol M et al 2005[15]	HCV	251	8.8 (56%; 91%)	0.79	14.6 (86%; 96%)	0.97
Sandrin et al 2003[13]	HCV	106		0.88		0.99

Cut-off values were those proposed by the authors. If more than one cut-off value was available, the value set for optimum diagnostic accuracy (i.e. cut-off at which sensitivity (se) + specificity (sp) is maximal) was used. Cut-off values are followed by the relevant sensitivity and specificity in parenthesis. HCV: Hepatitis C virus; HIV: Human immunodeficiency virus; PSC: Primary sclerosing cholangitis; PBC: Primary biliary cirrhosis.