Discordance in fibrosis staging between liver biopsy and transient elastography using the FibroScan XL probe

2012 Journal of Hepatology 56;3 (564-570)

BACKGROUND & AIMS: The FibroScan XL probe facilitates liver stiffness measurement (LSM) by transient elastography (TE) in obese patients, yet factors affecting its accuracy have not been described. Our objectives were to examine the prevalence, risk factors, and causes of discordance between fibrosis estimated by the FibroScan XL probe and biopsy. METHODS: Two hundred and ten patients with chronic liver disease (45% viral hepatitis, 55% nonalcoholic fatty liver disease (NAFLD) and a body mass index (BMI) >/= 28 kg/m(2)) underwent liver biopsy and TE with the FibroScan XL probe. Predictors of discordance >/= 2 fibrosis stages between measures, which occurred in 11% of patients (n=24), were identified by comparing patient, TE, and biopsy characteristics of discordant and non-discordant cases. RESULTS: Fibrosis estimated by the FibroScan XL probe was greater than biopsy in 75% (18/24) of discordant cases. Although biopsy quality was not associated with discordance, discordant cases were less likely to have >/= 10 valid shots (75% vs. 97%; p=0.001), a success rate >/= 60% (67% vs. 95%; p /= 40 kg/m(2): 32% vs. 8%) and liver stiffness above the median of 7.0 kPa (20% vs. 4%; both p

Pubmed : 22027584