A New Combined Non-invasive Method for Assessment of Liver Steatosis and Fibrosis in NAFLD Patients – Pilot Study

Authors

  • Teodora Komitova Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria
  • Rumiana Mitova Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria
  • Kaloyan Pavlov Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria
  • Klimentina Gerdzhikova Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria
  • Ivan Terziev Department of Clinical Pathology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria
  • Borislav Vladimirov Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria
  • Jordan Genov Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria

DOI:

https://doi.org/10.7546/CRABS.2023.03.14

Keywords:

CAP, HRI, steatosis, SWE, fibrosis

Abstract

The aim of this study was to investigate the clinical efficacy (sensitivity,  specificity) of ultrasound-based imaging methods for the assessment of fibrosis and steatosis in patients with non-àlcoholic fatty liver disease (NAFLD). Sixty-six patients with NAFLD and 43 healthy volunteers (control group) were tested. Liver biopsy was used as a reference method for the evaluation of NAFLD. Liver stiffness measurement (LSM) with transient elastography (TE) and two-dimensional shear wave elastography (2D-SWE) was used to assess fibrosis. Steatosis was assessed by Controlled Attenuation Parameter (CAP) and EchoLevels (ELs). Using the ELs, two hepato-renal indices were calculated – the hepato-renal index difference (HRIdiff) and hepato-renal index ratio (HRIratio). Additionally, one serum biomarker was calculated – APRI. Cut-offs of cirrhosis (F4) were defined as follows: ≥ 9.64 kPa and ≥ 9.85 kPa for 2D-SWE and TE. Only 2D-SWE had a correlation for significant fibrosis – the cut-off was ≥ 6.50 kPa and for lack of significant fibrosis (F < 2) less than 5.26 kPa. Steatosis was diagnosed with a cut-off of 240.50 dB/m for CAP, and HRIdiff ≥ 0.39, and HRIratio ≤ 0.99 for ELs. Both types of SWE and the two methods for evaluation of ultrasound (US) attenuation have good correlation with fibrosis and steatosis in NAFLD.

Author Biographies

Teodora Komitova, Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria

Mailing Address:
Medical University – Sofia,
Clinic of Gastroenterology,
University Hospital “Tsaritsa Yoanna – ISUL”
8 Byalo More St
1527 Sofia, Bulgaria

E-mail: tskomitova88@abv.bg

Rumiana Mitova, Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria

Mailing Address:
Medical University – Sofia,
Clinic of Gastroenterology,
University Hospital “Tsaritsa Yoanna – ISUL”
8 Byalo More St
1527 Sofia, Bulgaria

E-mail: rumi.mitova@gmail.com

Kaloyan Pavlov, Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria

Mailing Address:
Medical University – Sofia,
Clinic of Gastroenterology,
University Hospital “Tsaritsa Yoanna – ISUL”
8 Byalo More St
1527 Sofia, Bulgaria

E-mail: kalo.pavlov@gmail.com

Klimentina Gerdzhikova, Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria

Mailing Address:
Medical University – Sofia,
Clinic of Gastroenterology,
University Hospital “Tsaritsa Yoanna – ISUL”
8 Byalo More St
1527 Sofia, Bulgaria

E-mail: cinnammon@abv.bg

Ivan Terziev , Department of Clinical Pathology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria

Mailing Address:
Department of Clinical Pathology,
University Hospital “Tsaritsa Yoanna – ISUL”
8 Byalo More St
1527 Sofia, Bulgaria

E-mail: patologiaisul@abv.bg

Borislav Vladimirov, Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria

Mailing Address:
Medical University – Sofia,
Clinic of Gastroenterology,
University Hospital “Tsaritsa Yoanna – ISUL”
8 Byalo More St
1527 Sofia, Bulgaria

E-mail: borislavvladimirov@yahoo.com

Jordan Genov, Medical University – Sofia, Clinic of Gastroenterology, University Hospital “Tsaritsa Yoanna – ISUL”, Bulgaria

Mailing Address:
Medical University – Sofia,
Clinic of Gastroenterology,
University Hospital “Tsaritsa Yoanna – ISUL”
8 Byalo More St
1527 Sofia, Bulgaria

E-mail: jordan.georgiev.genov@gmail.com

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Published

27-03-2023

How to Cite

[1]
T. Komitova, “A New Combined Non-invasive Method for Assessment of Liver Steatosis and Fibrosis in NAFLD Patients – Pilot Study”, C. R. Acad. Bulg. Sci. , vol. 76, no. 3, pp. 448–456, Mar. 2023.

Issue

Section

Medicine