Technique Improves Liver Fibrosis Assessment in Chronic Hepatitis C

The use of the ElastPQ technique to assess fibrosis in chronic hepatitis C virus (HCV) patients was found to be accurate and reliable for staging liver fibrosis, a recent study found.

The primary goal of the study was to assess the performance in staging liver fibrosis of the updated ElastPQ technique in a real world setting by using the FibroScan as the reference of standard. Furthermore, researchers wanted to understand whether the use of the quality criteria improved the performance of the technique.

Researchers conducted a single center, cross-sectional study, which was published in the Journal of Gastrointestinal and Liver Diseases. In the study, there were 278 patients with chronic HCV who were referred for liver stiffness measurement (LSM) with the FibroScan 502 Touch device who underwent measurements with the ElastPQ technique, as well.

Researchers saw failures of LSMs in 8 (2.9%) of patients with ElastPQ and 1 (0.4%) with vibration controlled transient elastography (VCTE). This was because of obesity in 7 patients, and narrow intercostal spaces in 1 patient.

Unreliable results were seen in 14 patients with ElastPQ, and none with VCTE. These unreliable results were because of obesity in 4 cases, narrow intercostal spaces in 4 cases, and poor patient compliance in the remaining.

Measurements performed with both ElastPQ and VCTE were available for 91.7% of patients. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3), and cirrhosis (F=4), researchers used the cutoffs of 6.43, 9.54, and 11.34 kPa, respectively.

To assess the diagnostic performance of ElastPQ, researchers used the area under the ROC (AUROC) curve analysis with 10 measurements of and IQR/M≤30%; 5 measurements and IQR/M ≤30%; 10 measurements and IQR/M>30%; and 5 measurements and IQR/M>30%.

The results of the study showed that with measurements of IQR/M>30%; there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively).

The findings show that the updated version of the ElastPQ technique is both accurate and reliable for staging liver fibrosis, according to the study. Furthermore, the number of measurements did not affect the technique performance, and instead the criterion of IQR/M>30% should always be fulfilled, the researchers concluded.