ArticleClinics (Sao Paulo, Brazil)2017
Accuracy of transient elastography-FibroScan®, acoustic radiation force impulse (ARFI) imaging, the enhanced liver fibrosis (ELF) test, APRI, and the FIB-4 index compared with liver biopsy in patients with chronic hepatitis C.
Article in Clinics (Sao Paulo, Brazil), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Effects of glucagon-like peptide-1 receptor agonists and dual glucagon-like peptide-1 receptor agonists/glucose-dependent insulinotropic polypeptide on liver stiffness and steatosis evaluated through FibroscanInternal and emergency medicine · 2026Pooled it
- Pooled it
- Liver stiffness by non-invasive tests predicts hepatocellular carcinoma and liver-related complications following viral eradication with direct-acting antivirals in chronic hepatitis C: a retrospective cohort study.BMC gastroenterology · 2026Article
- Abnormal lipid profile in the context of liver steatosis measured by transient elastography: experiences from an outpatient endocrine clinic.Lipids in health and disease · 2026Article
- The Dual-Faceted Role of Metal-Based Nanomaterials in Hepatic Fibrosis Therapy.International journal of nanomedicine · 2026Review
- Evaluating the Diagnostic Potential of the FIB-4 Index for Cystic Fibrosis-Associated Liver Disease in Adults: A Comparison with Transient Elastography.Journal of clinical medicine · 2025Article
- Non-invasive liver fibrosis screening on CT images using radiomics.BMC medical imaging · 2025Article
- Underestimation of Liver Fibrosis Using Vibration-Controlled Transient Elastography on Cirrhosis. Are There Predictors?Canadian liver journal · 2025Article
- Evaluation of hepatic injury in chronic hepatitis B and C using APRI and FIB-4 indices compared to fibroscan results.Annals of medicine and surgery (2012) · 2024Article
- Noninvasive assessment of liver fibrosis can predict clinical outcomes at late follow-up after a sustained virological response in HCV patients?Clinics (Sao Paulo, Brazil) · 2024Article
- Temporal trends in HCV treatment uptake and success among people who inject drugs in Baltimore, MD since the introduction of direct acting antivirals.Drug and alcohol dependence · 2023Article
- APRI and FIB-4 indices as diagnostic noninvasive scores for prediction of severe fibrosis in patients with biliary atresia.Clinical and experimental hepatology · 2023Article
- Non-alcoholic fatty liver disease and incidence of microvascular complications of diabetes in patients with type 2 diabetes: a prospective cohort study.Frontiers in endocrinology · 2023Article
- HCV Infection and Liver Cirrhosis Are Associated with a Less-Favorable Serum Cholesteryl Ester Profile Which Improves through the Successful Treatment of HCV.Biomedicines · 2022Article
- Current aspects of renal dysfunction after liver transplantation.World journal of hepatology · 2022Review
- Fc receptor-like 5 gene polymorphisms and mRNA expression are associated with liver fibrosis in chronic hepatitis B.Frontiers in microbiology · 2022Article
- Nomogram for predicting advanced liver fibrosis and cirrhosis in patients with chronic liver disease.BMC gastroenterology · 2021Article
- Rapid Decline of Serum Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) in Non-Cirrhotic Patients with Chronic Hepatitis C Infection Receiving Direct-Acting Antiviral Therapy.Journal of clinical medicine · 2021Article
- Model for liver hardness using two-dimensional shear wave elastography, durometer, and preoperative biomarkers.World journal of gastrointestinal surgery · 2021Article
- ATA Index: A novel score for predicting fibrosis stage in chronic viral hepatitis.Hepatology forum · 2021Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAlthough liver biopsy is the gold standard for determining the degree of liver fibrosis, issues regarding its invasiveness and the small amount of liver tissue evaluated can limit its applicability and interpretation in clinical practice. Non-invasive evaluation methods for liver fibrosis can address some of these limitations. The aim of this study was to evaluate the accuracy of transient elastography-FibroScan®, acoustic radiation force impulse (ARFI), enhanced liver fibrosis (ELF), the aspartate aminotransferase-to-platelet ratio index (APRI), and the FIB-4 index compared with liver biopsy in hepatitis C.
methodsWe evaluated chronic hepatitis C patients who were followed at the Division of Clinical Gastroenterology and Hepatology, Hospital das Clínicas, Department of Gastroenterology of University of São Paulo School of Medicine, São Paulo, Brazil, and who underwent liver biopsy. The accuracy of each method was determined by a receiver operating characteristic (ROC) curve analysis, and fibrosis was classified as significant fibrosis (≥F2), advanced fibrosis (≥F3), or cirrhosis (F4). The Obuchowski method was also used to determine the diagnostic accuracy of each method at the various stages of fibrosis. In total, 107 FibroScan®, 51 ARFI, 68 ELF, 106 APRI, and 106 FIB-4 analyses were performed.
resultsA total of 107 patients were included in the study. The areas under the ROC curve (AUROCs) according to fibrosis degree were as follows: significant fibrosis (≥F2): FibroScan®: 0.83, FIB-4: 0.76, ELF: 0.70, APRI: 0.69, and ARFI: 0.67; advanced fibrosis (≥F3): FibroScan®: 0.85, ELF: 0.82, FIB-4: 0.77, ARFI: 0.74, and APRI: 0.71; and cirrhosis (F4): APRI: 1, FIB-4: 1, FibroScan®: 0.99, ARFI: 0.96, and ELF: 0.94. The accuracies of transient elastography, ARFI, ELF, APRI and FIB-4 determined by the Obuchowski method were F0-F1: 0.81, 0.78, 0.44, 0.72 and 0.67, respectively; F1-F2: 0.73, 0.53, 0.62, 0.60, and 0.68, respectively; F2-F3: 0.70, 0.64, 0.77, 0.60, and 0.67, respectively; and F3-F4: 0.98, 0.96, 0.82, 1, and 1, respectively.
conclusionTransient elastography remained the most effective method for evaluating all degrees of fibrosis. The accuracy of all methodologies was best at F4.
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