Underestimation of Liver Fibrosis Using Vibration-Controlled Transient Elastography on Cirrhosis. Are There Predictors?

Background: Detection of liver fibrosis helps to make therapeutic decisions and with screening in patients with chronic liver diseases. Transient elastography (TE) is an accurate, noninvasive technique to assess liver fibrosis but sometimes it is underestimated. Here we aimed for associations and predictors related to the underestimation of liver fibrosis using TE. Methods: We conducted a prospective cohort study involving adult patients with cirrhosis who underwent TE and had their clinical data analyzed. Patients were categorized into two groups based on liver stiffness measurement (LSM), either ≥10 kPa or <10 kPa, which was considered an underestimation of liver fibrosis. Multivariate analysis and logistic regression models were used to identify predictors and their associated strengths. One-way analysis of variance and multiple Tukey comparisons were used to determine the association with cirrhosis etiology. Results: Of 248 patients included, 29.4% had underestimation of liver fibrosis, and when compared with the ≥10 kPa group, significant differences were found in cirrhosis etiology ( Conclusions: Underestimation of liver fibrosis using TE in cirrhosis likely occurs with hepatitis C virus, nonalcoholic fatty liver disease, and low ALT levels.