studies

332A AASLD ABSTRACTS HEPATOLOGY, October, 2015
Aijaz Ahmed - Consulting: Bristol-Myers Squibb, Gilead Sciences Inc., Roche,
AbbVie, Salix Pharmaceuticals, Janssen pharmaceuticals, Vertex Pharmaceuticals,
Three Rivers Pharmaceuticals; Grant/Research Support: Gilead Sciences
Inc.
The following authors have nothing to disclose: Kellie Young, Maria Aguilar, Taft
Bhuket, Benny Liu, Robert J. Wong
238
Application of transient elastography and FibroMeter in
patients with nonalcoholic fatty liver disease
Vincent W. Wong 1 , Grace LH Wong 1 , Sally Shu 1 , Angel ML
Chim 1 , Anthony W. Chan 2 , Paul C. Choi 2 , Henry Lik-Yuen Chan 1 ;
1 Department of Medicine and Therapeutics, The Chinese University
of Hong Kong, Hong Kong, China; 2 Department of Anatomical
and Cellular Pathology, The Chinese University of Hong Kong,
Hong Kong, China
Background: Nonalcoholic fatty liver disease (NAFLD) has
emerged as a significant cause of cirrhosis and hepatocellular
carcinoma, but the majority of patients have relatively minor
disease. Hence, initial non-invasive assessments are preferred.
Liver stiffness measurement (LSM) by transient elastography
may fail in obese NAFLD patients. We therefore evaluated
the use of LSM and serum-based FibroMeter tests in NAFLD
patients. Methods: Consecutive liver biopsies for NAFLD were
evaluated using the Kleiner’s system. LSM and blood tests were
performed one day prior to liver biopsy. LSM was considered
reliable if 10 valid acquisitions were obtained and the interquartile
range-to-median ratio of LSM was ≤0.3. Cutoff values
for LSM (7.9 and 9.6 kPa for ≥F3 disease) and FibroMeter-NA-
FLD (0.62 for ≥F3 disease) were based on prior publications.
Results: 293 examinations were analyzed (age 50 years [SD
10], 54% males, body mass index 27.7 kg/m 2 [SD 4.2]).
The distribution of fibrosis stages was 38% F0, 30% F1, 9%
F2, 11% F3 and 12% F4. FibroMeter score was valid in all
patients. Among 233 patients undergoing LSM, 224 (96%)
had 10 valid acquisitions and 203 (87%) had reliable measurements.
In the overall population, the area under the receiver-operating
characteristics curve (AUROC) for FibroMeter was
0.72 (95% CI 0.66-0.78) for ≥F2, 0.73 (95% CI 0.67-0.80)
for ≥F3 and 0.79 (95% CI 0.72-0.87) for F4. At the cutoff of
0.62, the sensitivity, specificity, positive and negative predictive
values of FibroMeter for ≥F3 disease were 25%, 91%,
46% and 81%, respectively. In patients with reliable LSM, the
corresponding AUROC was 0.83 (95% CI 0.77-0.89), 0.91
(95% CI 0.87-0.95) and 0.91 (95% CI 0.86-0.97), respectively.
The LSM cutoff of 7.9 kPa had 93% sensitivity and 98%
negative predictive value in excluding ≥F3 disease. On the
other hand, the cutoff of 9.6 kPa had 86% specificity and
only 60% positive predictive value in ruling in ≥F3 disease. If
FibroMeter was performed in 113 patients with unreliable LSM
or LSM ≥7.9 kPa, 61 of 98 (62%) patients with a score