Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates

Background & Aims: Tools for the non-invasive diagnosis of non-alcoholic steatohepatitis (NASH) in morbidly obese patients with suspected non-alcoholic fatty liver disease (NAFLD) are an unmet clinical need. We prospectively compared the performance of transient elastography, MRI, and 3 seru...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Philippe Garteiser, Laurent Castera, Muriel Coupaye, Sabrina Doblas, Daniela Calabrese, Marco Dioguardi Burgio, Séverine Ledoux, Pierre Bedossa, Marina Esposito-Farèse, Simon Msika, Bernard E. Van Beers, Pauline Jouët
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Non-invasive diagnosis steatosis NAFLD NASH transient elastography CAP Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/98a3d0f8ce494edc851fc058cba53761
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:98a3d0f8ce494edc851fc058cba53761
record_format	dspace
spelling	oai:doaj.org-article:98a3d0f8ce494edc851fc058cba537612021-11-20T05:12:05ZProspective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates2589-555910.1016/j.jhepr.2021.100381https://doaj.org/article/98a3d0f8ce494edc851fc058cba537612021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589555921001579https://doaj.org/toc/2589-5559Background & Aims: Tools for the non-invasive diagnosis of non-alcoholic steatohepatitis (NASH) in morbidly obese patients with suspected non-alcoholic fatty liver disease (NAFLD) are an unmet clinical need. We prospectively compared the performance of transient elastography, MRI, and 3 serum scores for the diagnosis of NAFLD, grading of steatosis and detection of NASH in bariatric surgery candidates. Methods: Of 186 patients screened, 152 underwent liver biopsy, which was used as a reference for NAFLD (steatosis [S]>5%), steatosis grading and NASH diagnosis. Biopsies were read by a single expert pathologist. MRI-based proton density fat fraction (MRI-PDFF) was measured in an open-bore, vertical field 1.0T scanner and controlled attenuation parameter (CAP) was measured by transient elastography, using the XL probe. Serum scores (SteatoTest, hepatic steatosis index and fatty liver index) were also calculated. Results: The applicability of MRI was better than that of FibroScan (98% vs. 79%; p <0.0001). CAP had AUROCs of 0.83, 0.79, 0.73 and 0.69 for S>5%, S>33%, S>66% and NASH, respectively. Transient elastography had an AUROC of 0.80 for significant fibrosis (F0-F1 vs. F2-F3). MRI-PDFF had AUROCs of 0.97, 0.95, 0.92 and 0.84 for S>5%, S>33%, S>66% and NASH, respectively. When compared head-to-head in the 97 patients with all valid tests available, MRI-PDFF outperformed CAP for grading steatosis (S>33%, AUROC 0.97 vs. 0.78; p <0.0003 and S>66%, AUROC 0.93 vs. 0.75; p = 0.0015) and diagnosing NASH (AUROC 0.82 vs. 0.68; p = 0.0056). When compared in “intention to diagnose” analysis, MRI-PDFF outperformed CAP, hepatic steatosis index and fatty liver index for grading steatosis (S>5%, S>33% and S>66%). Conclusion: MRI-PDFF outperforms CAP for diagnosing NAFLD, grading steatosis and excluding NASH in morbidly obese patients undergoing bariatric surgery. Lay summary: Non-invasive tests for detecting fatty liver and steatohepatitis, the active form of the disease, have not been well studied in obese patients who are candidates for bariatric surgery. The most popular tests for this purpose are Fibroscan, which can be used to measure the controlled attenuation parameter (CAP), and magnetic resonance imaging, which can be used to measure the proton density fat fraction (MRI-PDFF). We found that, when taking liver biopsy as a reference, MRI-PDFF performed better than CAP for detecting and grading fatty liver as well as excluding steatohepatitis in morbidly obese patients undergoing bariatric surgery.Philippe GarteiserLaurent CasteraMuriel CoupayeSabrina DoblasDaniela CalabreseMarco Dioguardi BurgioSéverine LedouxPierre BedossaMarina Esposito-FarèseSimon MsikaBernard E. Van BeersPauline JouëtElsevierarticleNon-invasive diagnosissteatosisNAFLDNASHtransient elastographyCAPDiseases of the digestive system. GastroenterologyRC799-869ENJHEP Reports, Vol 3, Iss 6, Pp 100381- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Non-invasive diagnosis steatosis NAFLD NASH transient elastography CAP Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Non-invasive diagnosis steatosis NAFLD NASH transient elastography CAP Diseases of the digestive system. Gastroenterology RC799-869 Philippe Garteiser Laurent Castera Muriel Coupaye Sabrina Doblas Daniela Calabrese Marco Dioguardi Burgio Séverine Ledoux Pierre Bedossa Marina Esposito-Farèse Simon Msika Bernard E. Van Beers Pauline Jouët Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates
description	Background & Aims: Tools for the non-invasive diagnosis of non-alcoholic steatohepatitis (NASH) in morbidly obese patients with suspected non-alcoholic fatty liver disease (NAFLD) are an unmet clinical need. We prospectively compared the performance of transient elastography, MRI, and 3 serum scores for the diagnosis of NAFLD, grading of steatosis and detection of NASH in bariatric surgery candidates. Methods: Of 186 patients screened, 152 underwent liver biopsy, which was used as a reference for NAFLD (steatosis [S]>5%), steatosis grading and NASH diagnosis. Biopsies were read by a single expert pathologist. MRI-based proton density fat fraction (MRI-PDFF) was measured in an open-bore, vertical field 1.0T scanner and controlled attenuation parameter (CAP) was measured by transient elastography, using the XL probe. Serum scores (SteatoTest, hepatic steatosis index and fatty liver index) were also calculated. Results: The applicability of MRI was better than that of FibroScan (98% vs. 79%; p <0.0001). CAP had AUROCs of 0.83, 0.79, 0.73 and 0.69 for S>5%, S>33%, S>66% and NASH, respectively. Transient elastography had an AUROC of 0.80 for significant fibrosis (F0-F1 vs. F2-F3). MRI-PDFF had AUROCs of 0.97, 0.95, 0.92 and 0.84 for S>5%, S>33%, S>66% and NASH, respectively. When compared head-to-head in the 97 patients with all valid tests available, MRI-PDFF outperformed CAP for grading steatosis (S>33%, AUROC 0.97 vs. 0.78; p <0.0003 and S>66%, AUROC 0.93 vs. 0.75; p = 0.0015) and diagnosing NASH (AUROC 0.82 vs. 0.68; p = 0.0056). When compared in “intention to diagnose” analysis, MRI-PDFF outperformed CAP, hepatic steatosis index and fatty liver index for grading steatosis (S>5%, S>33% and S>66%). Conclusion: MRI-PDFF outperforms CAP for diagnosing NAFLD, grading steatosis and excluding NASH in morbidly obese patients undergoing bariatric surgery. Lay summary: Non-invasive tests for detecting fatty liver and steatohepatitis, the active form of the disease, have not been well studied in obese patients who are candidates for bariatric surgery. The most popular tests for this purpose are Fibroscan, which can be used to measure the controlled attenuation parameter (CAP), and magnetic resonance imaging, which can be used to measure the proton density fat fraction (MRI-PDFF). We found that, when taking liver biopsy as a reference, MRI-PDFF performed better than CAP for detecting and grading fatty liver as well as excluding steatohepatitis in morbidly obese patients undergoing bariatric surgery.
format	article
author	Philippe Garteiser Laurent Castera Muriel Coupaye Sabrina Doblas Daniela Calabrese Marco Dioguardi Burgio Séverine Ledoux Pierre Bedossa Marina Esposito-Farèse Simon Msika Bernard E. Van Beers Pauline Jouët
author_facet	Philippe Garteiser Laurent Castera Muriel Coupaye Sabrina Doblas Daniela Calabrese Marco Dioguardi Burgio Séverine Ledoux Pierre Bedossa Marina Esposito-Farèse Simon Msika Bernard E. Van Beers Pauline Jouët
author_sort	Philippe Garteiser
title	Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates
title_short	Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates
title_full	Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates
title_fullStr	Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates
title_full_unstemmed	Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates
title_sort	prospective comparison of transient elastography, mri and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/98a3d0f8ce494edc851fc058cba53761
work_keys_str_mv	AT philippegarteiser prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT laurentcastera prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT murielcoupaye prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT sabrinadoblas prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT danielacalabrese prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT marcodioguardiburgio prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT severineledoux prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT pierrebedossa prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT marinaespositofarese prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT simonmsika prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT bernardevanbeers prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates AT paulinejouet prospectivecomparisonoftransientelastographymriandserumscoresforgradingsteatosisanddetectingnonalcoholicsteatohepatitisinbariatricsurgerycandidates
_version_	1718419556503912448

Prospective comparison of transient elastography, MRI and serum scores for grading steatosis and detecting non-alcoholic steatohepatitis in bariatric surgery candidates

Ejemplares similares