studies

1290A AASLD ABSTRACTS HEPATOLOGY, October, 2015
2220
Transient Elastography is Feasible with High Success
Rate for Evaluation of Non-Alcoholic Fatty Liver Disease
(NAFLD) in a Multicenter Setting
Raj Vuppalanchi 1 , Mohammad S. Siddiqui 2 , Erin K. Hallinan
3 , Manal F. Abdelmalek 4 , Brent A. Neuschwander-Tetri 5 ,
Rohit Loomba 6 , Kris V. Kowdley 7 , Norah Terrault 8 , Arthur J.
McCullough 9 , James Tonascia 3 , Elizabeth M. Brunt 10 , David E.
Kleiner 11 , Edward Doo 12 , Naga P. Chalasani 1 , Arun J. Sanyal 2 ;
1 Indiana University, Indianapolis, IN; 2 Virginia Commonwealth,
Richmond, VA; 3 Johns Hopkins Bloomberg School of Public Health,
Baltimore, MD; 4 Duke, Durham, NC; 5 St.Louis University, St.Louis,
MO; 6 University of California at San Diego, San Diego, CA;
7 Swedish Medical Center, Seattle, WA; 8 University of California at
San Francisco, San Francisco, CA; 9 Cleveland Clinic, Cleveland,
OH; 10 Washington University, St.Louis, MO; 11 NCI, Bethesda,
MD; 12 NIH, Bethesda, MD
Background: Vibration-controlled transient elastography using
FibroScan to obtain the liver stiffness measurement (LSM) and
controlled attenuation parameter (CAP) is a promising non-invasive
tool for assessment of hepatic fibrosis and steatosis
respectively. However, prior studies using older versions of
FibroScan reported high failure rates in nonalcoholic fatty liver
disease (NAFLD). Aim: The aim of the current study was to
examine the feasibility and success of the FibroScan 502 Touch
in patients with NAFLD who were participating the NAFLD
Database Study conducted by the NASH Clinical Research
Network (NASH CRN). Methods: A total of 511 NAFLD
patients across eight clinical centers were eligible and provided
informed consent. The FibroScan 502 Touch was used in
all patients with either the medium (M+) or large (XL+) probes.
Both LSM and CAP were measured after an overnight fast
using a standardized protocol. The scanning was performed
twice (FS1 and FS2) during the same study visit. “Failure” was
defined as the inability to obtain a valid exam whereas “unreliable”
was defined as those exams with 30%. Results: The cohort
included 65% women with a mean (± SD) age of 56 (± 12)
years, BMI 33.6 (± 6.8) kg/m 2 and waist circumference 107
(± 14) cm. Based on the recommendations from the automatic
probe selection tool, XL+ probe was required for the study in
57% of patients. Five patients (1.0%) refused the procedure
after providing informed consent and five patients (1.0%) had
a skin-to-capsule distance greater than 3.5 cm and the exam
could not be completed. Among remaining 501 patients, the
results were unreliable in 8 (1.6%). Using logistic regression
analysis, only female gender [OR: 0.29, 95%CI: 0.10, 0.83,
p=0.02) and waist circumference [OR: 1.04 per cm, 95%CI:
1.01, 1.08, p=0.004) were associated with a failed or unreliable
exam. There was excellent agreement between FS1 and
FS2 for LSM (r=0.96, 95% CI: 0.95, 0.97) and CAPs (r=0.81,
95% CI: 0.77, 0.84). In a subset of patients who had a liver
biopsy within 12 months of the FibroScan (n=74), log-linear
regression analysis showed statistically significant relationships
between the geometric mean (GM) LSM and advanced (stage
3 or 4) vs. no or less advanced fibrosis [GM ratio: 2.04 (95%
CI: 1.60, 2.60), p