Real-time elastography with a novel quantitative technology for assessment of liver fibrosis in chronic hepatitis B.

BACKGROUND The accurate evaluation of liver fibrosis stage is important in determining the treatment strategy. The limitations of percutaneous liver biopsy as the gold standard are obvious for invasion. Real-time elastography with conventional ultrasound probes and a new quantitative technology for diffuse histological lesion is a novel approach for staging of liver fibrosis. PURPOSE This study aimed to evaluate the value of real-time tissue elastography with a new quantitative technology for the assessment of liver fibrosis stage. MATERIALS AND METHODS Real-time elastography was performed in 55 patients with liver fibrosis and chronic hepatitis B and in 20 healthy volunteers. Eleven parameters for every patient in colorcode image obtained from the real-time elastography were analyzed with principal components analysis. We analyzed the correlation between elasticity index and liver fibrosis stage and the accuracy of real-time elastography for liver fibrosis staging. Additionally, aspartate transaminase-to-platelet ratio index was also included in the analysis. RESULTS The Spearman's correlation coefficient between the elasticity index and the histologic fibrosis stage was 0.81, which is highly significant (p<0.001). The areas under receiver operating characteristic curves indicating diagnostic accuracy were 0.93 (F≥F1, p<0.001) for the diagnosis of liver fibrosis, 0.92 (F≥F2, p<0.001), 0.84 (F≥F3, p<0.05) and 0.66 (F=F4, p>0.05), respectively. CONCLUSIONS Real-time elastography with a new quantitative technology for diffuse histological lesion is a new and promising sonography-based noninvasive method for the assessment of liver fibrosis in patients with chronic hepatitis B.