ArticleHepatology (Baltimore, Md.)2021
Accuracy of Transient Elastography in Assessing Fibrosis at Diagnosis in Naïve Patients With Primary Biliary Cholangitis: A Dual Cut-Off Approach.
Article in Hepatology (Baltimore, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- KASL clinical practice guidelines for noninvasive tests to assess liver fibrosis in chronic liver disease.Clinical and molecular hepatology · 2024Guideline
- Diagnostic role of transient elastography in patients with autoimmune liver diseases: A systematic review and meta-analysis.World journal of gastroenterology · 2023Pooled it
- Impact of Type 2 Diabetes Mellitus on Liver Fibrosis and Hepatic Steatosis in Patients with Primary Biliary Cholangitis: A Longitudinal Study.Digestive diseases and sciences · 2026Article
- Dual cut-offs and beyond: Expanding the role of transient elastography in primary biliary cholangitis.World journal of gastroenterology · 2026Article
- Serum matrix metalloproteinase-7 as a diagnostic and prognostic biomarker in primary biliary cholangitis.Frontiers in medicine · 2026Article
- The Personalized Management of Primary Biliary Cholangitis in the Era of Precision Medicine: Current Challenges and Future Perspectives.Journal of personalized medicine · 2025Review
- Trends in Primary Biliary Cholangitis: Prospective Cohort Study From the European Reference Network Registry (R-LIVER).United European gastroenterology journal · 2025Article
- Real-world performance of transient elastography in assessing advanced fibrosis in Chinese patients with primary biliary cholangitis.World journal of gastroenterology · 2025Article
- The Treatment of Primary Biliary Cholangitis: Time for Personalized Medicine.Clinical reviews in allergy & immunology · 2025Review
- Low-risk individuals with primary biliary cholangitis and significant liver stiffness: prognosis and treatment.Hepatology international · 2025Article
- Gd-EOB-DTPA-Enhanced Magnetic Resonance Imaging for Assessing Liver Function in Primary Biliary CholangitisCurrent medical imaging · 2025Article
- Innate immunity of bile and cholangiocytes in primary biliary cholangitis.Frontiers in immunology · 2025Review
- Novel noninvasive indices for the assessment of liver fibrosis in primary biliary cholangitis.Biomedical reports · 2024Article
- Risk Stratification in Primary Biliary Cholangitis.Journal of clinical medicine · 2023Review
- Non-Invasive Measurement of Hepatic Fibrosis by Transient Elastography: A Narrative Review.Viruses · 2023Review
- Prognostic utility of albumin-bilirubin grade in Japanese patients with primary biliary cholangitis.JHEP reports : innovation in hepatology · 2023Article
- TR score: A noninvasive model to predict histological stages in patients with primary biliary cholangitis.Frontiers in immunology · 2023Article
- Role of ductular reaction and ductular-canalicular junctions in identifying severe primary biliary cholangitis.JHEP reports : innovation in hepatology · 2022Article
- Clinical characterization of patients with primary biliary cholangitis: A report from multiple Canadian centres.Canadian liver journal · 2022Article
- Update on the role of elastography in liver disease.Therapeutic advances in gastroenterology · 2022Review
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Authors and funding
37 authors at 11 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsLiver fibrosis holds a relevant prognostic meaning in primary biliary cholangitis (PBC). Noninvasive fibrosis evaluation using vibration-controlled transient elastography (VCTE) is routinely performed. However, there is limited evidence on its accuracy at diagnosis in PBC. We aimed to estimate the diagnostic accuracy of VCTE in assessing advanced fibrosis (AF) at disease presentation in PBC. APPROACH AND
resultsWe collected data from 167 consecutive treatment-naïve PBC patients who underwent liver biopsy (LB) at diagnosis at six Italian centers. VCTE examinations were completed within 12 weeks of LB. Biopsies were scored by two blinded expert pathologists, according to the Ludwig system. Diagnostic accuracy was estimated using the area under the receiver operating characteristic curves (AUROCs) for AF (Ludwig stage ≥III). Effects of biochemical and clinical parameters on liver stiffness measurement (LSM) were appraised. The derivation cohort consisted of 126 patients with valid LSM and LB; VCTE identified patients with AF with an AUROC of 0.89. LSM cutoffs ≤6.5 and >11.0 kPa enabled to exclude and confirm, respectively, AF (negative predictive value [NPV] = 0.94; positive predictive value [PPV] = 0.89; error rate = 5.6%). These values were externally validated in an independent cohort of 91 PBC patients (NPV = 0.93; PPV = 0.89; error rate = 8.6%). Multivariable analysis found that the only parameter affecting LSM was fibrosis stage. No association was found with BMI and liver biochemistry.
conclusionsIn a multicenter study of treatment-naïve PBC patients, we identified two cutoffs (LSM ≤6.5 and >11.0 kPa) able to discriminate at diagnosis the absence or presence, respectively, of AF in PBC patients, with external validation. In patients with LSM between these two cutoffs, VCTE is not reliable and liver biopsy should be evaluated for accurate disease staging. BMI and liver biochemistry did not affect LSMs.
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