Utility of Liver Stiffness Measurement by Transient Elastrography (Fibroscan) for the Diagnosis of Cirrhosis in Chronic Hepatitis

Objective: To diagnose the cirrhosis in chronic hepatitis patients by liver stiffness measured by transient elastrography (Fibroscan) Methods: A prospective descriptive study comprised 102 adult patients underwent transient elastrography during July 2009 in liver clinic at BMA Medical College and Vajira Hospital. There were a comprising of chronic hepatitis B, chronic hepatitis C, NASH, alcoholic hepatitis and healthy subjects. Liver stiffness measurement was performed. An investigator was blinded whether they were cirrhosis or not. The main outcomes measured were liver stiffness measurement value presented as kilopascal (kPa) and the presence of liver cirrhosis Results: There were 102 patients who aged between 20-82 years that were divided into 16 normal volunteer (15.6%), 69 chronic hepatitis patients (67.6%) and 17 cirrhotic patients (16.6%). Liver stiffness of cirrhosis, chronic hepatitis and normal volunteer were 33.9, 6.5 and 4.2 kPa respectively. In cirrhotic patients, liver stiffness measurement resulted in the range from 10.4 to 75 kPa. Mean kPa of cirrhotic patients was significantly higher than chronic hepatitis patients (33.3 Vs 6.5; p < 0.005). Furthermore, decompensated cirrhotic patients had significantly higher mean of kPa than compensated cirrhosis (43.4 Vs 24.16; p = 0.035). Area under the receiver operating characteristic curve was 0.924 for a diagnosis of cirrhosis by using a cut-off value at 13 kPa. This cut-off value gave a positive predictive value and a negative predictive value of 83.3 and 97.6 % respectively. Conclusion: Liver stiffness measurement by transient elastrography using a cut-off value at 13 kPa could be utilized for the diagnosis of early cirrhosis in chronic hepatitis patients.