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©2009 The WJG Press and Baishideng.
World J Gastroenterol. Jul 21, 2009; 15(27): 3398-3404
Published online Jul 21, 2009. doi: 10.3748/wjg.15.3398
Published online Jul 21, 2009. doi: 10.3748/wjg.15.3398
Table 1 Characteristics of included and non-included patients n (%)
Characteristics | Included | Non-included |
Number of patients | 442 | 26 |
Mean age (SE) | 49 (1) | 50 (2) |
Male | 293 (66) | 17 (65) |
Ethnic origin | ||
Caucasian | 285 (65) | 17 (65) |
Asian | 36 (8) | 2 (8) |
North African | 43 (10) | 1 (4) |
Other African | 78 (17) | 6 (23) |
Anthropometric data | ||
Height (m) | 1.71 (0.05) | 1.70 (1.91) |
Weight (kg) | 71.7 (0.7) | 69.7 (2.4) |
BMI (kg/m2) | 24.4 (0.2) | 24.1 (0.8) |
Abdominal fold mm | 21.7 (0.5) | 26.1 (3.2) |
Thoracic fold mm | 13.1 (0.3) | 13.6 (1.1) |
Waist circumference cm | 84 (1) | 83 (2) |
Daily alcohol ≥ 30 g/d | 18 (7) | 2 (11) |
Diagnosis | ||
HCV | 200 (45) | 13 (50) |
HBV | 79 (18) | 6 (23) |
NAFLD | 59 (13) | 1 (4) |
HIV coinfection | 50 (11) | 4 (15) |
ALD | 11 (3) | 0 (0) |
Other/unknown | 93 (21) | 2 (8) |
Biochemistry | ||
ALT (IU/L) | 58 (3) | 151 (100) |
AST (IU/L) | 48 (2) | 45 (6) |
n = 416 | n = 16 | |
Cholesterol (mmol/L) | 4.70 (0.05) | 4.50 (0.34) |
n = 381 | n = 14 | |
Glucose (mmol/L) | 5.34 (0.07) | 5.28 (0.16) |
n = 404 | n = 16 | |
Triglycerides (mmol/L) | 1.21 (0.06) | 1.10 (0.19) |
n = 381 | n = 14 | |
FibroTest | 0.40 (0.01) | 0.51 (0.06) |
n = 442 | n = 18 | |
ActiTest | 0.32 (0.01) | 0.39 (0.07) |
n = 442 | n = 18 | |
SteatoTest | 0.33 (0.01) | 0.27 (0.06) |
n = 378 | n = 12 |
Table 2 Liver stiffness measurements applicability
Position, operator and quality criteria | Applicability (%) | Presumed fibrosis stages among applicable patients F0F1/F2/F3/F4 n (%)c |
Reference position | 306/442 (69)a | 167 (55)/59 (19)/51 (17)/29 (9)d |
Operator 1 | 208/329 (63) | 117 (56)/40 (19)/32 (15)/19 (9) |
Valid10 | 312/329 (95) | |
SR60 | 300/329 (91) | |
IQR30 | 220/329 (67) | |
Operator 2 | 98/113 (87) | 50 (51)/19 (19)/19 (19)/10 (10) |
Valid10 | 113/113 (100) | |
SR60 | 113/113 (100) | |
IQR30 | 98/113 (87) | |
Anterior position | 357/442 (81)a | 223 (62)/52 (15)/49 (14)/33 (9)d |
Operator 1 | 255/329 (78) | 166 (65)/34 (13)/31 (12)/24 (9) |
Valid10 | 300/329 (91) | |
SR60 | 296/329 (90) | |
IQR30 | 271/329 (82)b | |
Operator 2 | 102/113 (90) | 57 (56)/18 (18)/18 (18)/9 (9) |
Valid10 | 111/113 (98) | |
SR60 | 111/113 (98) | |
IQR30 | 103/113 (91)b | |
Lower position | 302/442 (68)a | 170 (56)/49 (16)/47 (16)/36 (12) |
Operator 1 | 224/329 (68) | 126 (56)/36 (16)/36 (16)/26 (12) |
Valid10 | 299/329 (91) | |
SR60 | 291/329 (88) | |
IQR30 | 240/329 (73)b | |
Operator 2 | 78/113 (69) | 44 (56)/13 (17)/11 (14)/10 (13) |
Valid10 | 96/113 (85) | |
SR60 | 94/113 (83) | |
IQR30 | 86/113 (76)b |
Table 3 Strength of concordance between stiffness measurements assessed in three positions in the biopsy area
Position (No. of patients) | Method assessing concordance | |
Quantitative concordance | Spearman mean (95% CI) | Intra class coefficient mean (95% CI) |
Reference vs anterior (196) | 0.81 (0.75-0.85) | 0.90 (0.86-0.94) |
Reference vs lower (196) | 0.77 (0.70-0.82) | 0.86 (0.79-0.93) |
Anterior vs lower (196) | 0.77 (0.70-0.82) | 0.87 (0.80-0.94) |
Two classes concordance | Discordance rate (%) | Kappa mean (SE) |
Advanced vs non advanced fibrosis | ||
7.1 cutoff | ||
Reference vs anterior (196) | 35 (17.9)a | 0.63 (0.07) |
Reference vs lower (196) | 33 (16.8)b | 0.66 (0.07) |
Anterior vs lower (196) | 34 (17.3)c | 0.64 (0.07) |
8.8 cutoff | ||
Reference vs anterior (196) | 22 (11.2) | 0.71 (0.07) |
Reference vs lower (196) | 28 (14.3) | 0.65 (0.07) |
Anterior vs lower (196) | 20 (10.2) | 0.74 (0.07) |
Table 4 Factors associated with discordance between reference and anterior positions n (%)
Characteristics | Concordant | Discordant | P |
Number of patients | 221 | 47 | |
Mean age (SE) | 47 (1) | 49 (2) | 0.16 |
Male | 151 (68) | 34 (72) | 0.59 |
Ethnic origin | |||
Caucasian | 134 (61) | 30 (64) | 0.69 |
Asian | 16 (7) | 4 (8) | 0.68 |
North African | 27 (12) | 6 (13) | 0.87 |
Other African | 44 (20) | 7 (15) | 0.38 |
Anthropometric data | |||
Height (m) | 1.71 (0.01) | 1.71 (0.10) | 0.96 |
Weight (kg) | 69.8 (0.9) | 73.6 (2.2) | 0.12 |
BMI (kg/m2) | 23.7 (0.2) | 25.0 (0.5) | 0.02 |
Abdominal fold (mm) | 19.2 (0.6) | 23.0 (1.6) | 0.03 |
Thoracic fold (mm) | 11.4 (0.4) | 14.5 (0.9) | 0.001 |
Waist circumference (cm) | 82 (1) | 86 (2) | 0.047 |
Daily alcohol ≥ 30 g/d | 18/137 (13) | 2/23 (9) | 0.55 |
Diagnosis | |||
HCV | 102 (46) | 18 (38) | 0.29 |
HBV | 44 (20) | 9 (19) | 0.88 |
NAFLD | 21 (10) | 11 (23) | 0.002 |
HIV coinfection | 29 (13) | 5 (11) | 0.63 |
ALD | 8 (4) | 0 (0) | 0.16 |
Other | 46 (20) | 9 (19) | 0.88 |
Biochemistry | |||
ALT (IU/L) | 55 (3) | 81 (19) | 0.56 |
n = 221 | n = 47 | ||
AST (IU/L) | 47 (2) | 57 (6) | 0.54 |
n = 221 | n = 47 | ||
Cholesterol (mmol/L) | 4.63 (0.08) | 4.85 (0.13) | 0.06 |
n = 186 | n = 42 | ||
Glucose (mmol/L) | 5.26 (0.09) | 5.42 (0.17) | 0.15 |
n = 197 | n = 46 | ||
Triglycerides (mmol/L) | 1.15 (0.06) | 1.37 (0.19) | 0.10 |
n = 186 | n = 42 | ||
FibroTest | 0.40 (0.01) | 0.41 (0.06) | 0.76 |
n = 221 | n = 47 | ||
ActiTest | 0.32 (0.02) | 0.34 (0.04) | 0.59 |
n = 221 | n = 18 | ||
SteatoTest | 0.30 (0.01) | 0.38 (0.04) | 0.04 |
n = 183 | n = 42 |
Table 5 Strength of concordance between LSM and FibroTest (FT) according to positions
Position (No. of patients) | Method assessing | Kappa |
Discordance rate (%) | ||
Quantitative concordance | Spearman mean (95% CI) | Intra class coefficient mean (95% CI) |
All positions applicable | ||
Reference (196) | 0.46 (0.34-0.56) | 0.55 (0.33-0.67) |
Anterior (196) | 0.46 (0.34-0.56) | 0.56 (0.34-0.68) |
Lower (196) | 0.40 (0.27-0.51) | 0.50 (0.38-0.62) |
Mean of positions (196) | 0.47 (0.35-0.57) | 0.56 (0.34-0.68) |
At least one position applicable | ||
Reference (306) | 0.44 (0.35-0.53) | 0.51 (0.39-0.63) |
Anterior (357) | 0.46 (0.38-0.54) | 0.54 (0.32-0.66) |
Lower (302) | 0.39 (0.29-0.49) | 0.50 (0.38-0.62) |
Two classes concordance | Discordance rate n (%) | Kappa mean (SE) |
Cutoff 7.1 kPa | ||
All positions applicable | ||
Reference (196) | 66 (33.6)a | 0.30 (0.07) |
Anterior (196) | 61 (31.1) | 0.32 (0.07) |
Lower (196) | 71 (36.2) | 0.24 (0.07) |
Mean of positions (196) | 67 (34.2) | 0.28 (0.07) |
At least one position applicable | ||
Reference (306) | 107 (34.9)b | 0.28 (0.06) |
Anterior (357) | 112 (31.6) | 0.33 (0.05) |
Lower (302) | 109 (36.1)c | 0.24 (0.06) |
Cutoff 8.8 kPa | ||
All positions applicable | ||
Reference (196) | 46 (23.5)a | 0.45 (0.07) |
Anterior (196) | 54 (27.6) | 0.33 (0.07) |
Lower (196) | 56 (28.6) | 0.34 (0.07) |
Mean of positions (196) | 52 (26.5) | 0.37 (0.07) |
At least one position applicable | ||
Reference (306) | 82 (26.8)b | 0.38 (0.06) |
Anterior (357) | 108 (30.2) | 0.30 (0.05) |
Lower (302) | 84 (27.8)c | 0.34 (0.06) |
- Citation: Ingiliz P, Chhay KP, Munteanu M, Lebray P, Ngo Y, Roulot D, Benhamou Y, Thabut D, Ratziu V, Poynard T. Applicability and variability of liver stiffness measurements according to probe position. World J Gastroenterol 2009; 15(27): 3398-3404
- URL: https://www.wjgnet.com/1007-9327/full/v15/i27/3398.htm
- DOI: https://dx.doi.org/10.3748/wjg.15.3398