Transient elastography of liver fibrosis in chronic hepatitis C patients: Diagnostic importance

Document Type





Title: Transient Elastography of Liver Fibrosis in Chronic Hepatitis C patients: Diagnostic Importance.
Objective: To determine the diagnostic accuracy of Transient Elastography of liver in assessing fibrosis in adult chronic Hepatitis C patients keeping liver biopsy as gold standard.
Subjects and Methods: This cross-sectional study was conducted at the Radiology department of Civil Hospital Karachi, Pakistan from May 2014 to January 2015. Consecutive adult patients aged 18 to 60 years with presence of HCV RNA in serum according to polymerase chain reaction, and minimum of 6 months duration of known Hepatitis C were included in the study. All patients underwent transient elastography of liver by a consultant radiologist and the Principal investigator. Ten valid measurements were taken and mean value was classified accordingly (F0-F4). The elastography scores were correlated with METAVIR scores of liver biopsy. Diagnostic accuracy was determined in terms of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).
Results: Transient elastography correctly identified presence of fibrosis in 190 (95.4%) out of 199 patients with fibrosis and ruled out fibrosis in 63 (88.7%) of 71 patients with normal liver on histopathology. The diagnostic accuracy of transient elastography in determining the presence of fibrosis was: Sensitivity 95.5%, specificity 87.5%, PPV 95.5% and NPV 88.7%. However, for assessing the stage of fibrosis the sensitivity and specificity respectively were 80% and 95.23% for F1, 79.6% and 96.29% for F2, 88% and 96.61% for F3, and 98% and 99.54% for F4.
Conclusion: Transient elastography has high diagnostic accuracy in determining the presence of fibrosis as well as in assessing late fibrosis and cirrhosis (F3-F4). However, the sensitivity was comparatively less in identification of early fibrosis (F1-F2) in the studied group of patients.

Publication (Name of Journal)

Pakistan Journal of Radiology