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Article: The use of transient elastography in the management of chronic hepatitis B
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TitleThe use of transient elastography in the management of chronic hepatitis B
 
AuthorsFung, J1
Lai, CL1
Seto, WK1
Yuen, MF1
 
KeywordsFibroscan
Liver fibrosis
Noninvasive
 
Issue Date2011
 
PublisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0
 
CitationHepatology International, 2011, v. 5 n. 4, p. 868-875 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s12072-011-9288-5
 
AbstractThere has been increasing interest in noninvasive methods of assessing liver fibrosis over the last decade. The use of transient elastography in measuring liver stiffness has become the forefront of a wide range of noninvasive tools. Most of the other methods are based on measurements of biomarkers associated with fibrosis. There are several reasons for its wide acceptance, including the ease of performing a scan, the short procedure time, the results being immediately available on completion of the examination, and its reproducibility. For chronic hepatitis B (CHB), the cut-off values for F3 and F4 fibrosis range between 7.5-12.0 and 11.0-13.4 kPa, respectively, although the cut-offs may be slightly lower in those with normal ALT. In addition to measuring liver fibrosis, recent studies have demonstrated several other roles for transient elastography, including selecting patients who will benefit from antiviral therapy, monitoring response to antiviral therapy, and predicting long-term outcomes. However, there are limitations associated with transient elastography, including the confounding effects of inflammatory activity, and to a lesser extent, steatosis, on liver stiffness. There is also reduced accuracy observed in lower fibrosis stages (F0-F2). Furthermore, the incidences of failed and unreliable scan have been reported to be ~ 3 and 16%, respectively. Although liver biopsy can be avoided in an estimated 50-60% using transient elastography, in situations where liver stiffness measurement is nondiagnostic or inconsistent with the clinical picture, a biopsy is still recommended. Further studies are needed to consolidate the role of transient elastography in the management of CHB, and for incorporation of this method into current treatment guidelines. © 2011 The Author(s).
 
ISSN1936-0533
2013 Impact Factor: 2.468
 
DOIhttp://dx.doi.org/10.1007/s12072-011-9288-5
 
PubMed Central IDPMC3215876
 
ISI Accession Number IDWOS:000297133500002
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorFung, J
 
dc.contributor.authorLai, CL
 
dc.contributor.authorSeto, WK
 
dc.contributor.authorYuen, MF
 
dc.date.accessioned2012-02-21T05:44:22Z
 
dc.date.available2012-02-21T05:44:22Z
 
dc.date.issued2011
 
dc.description.abstractThere has been increasing interest in noninvasive methods of assessing liver fibrosis over the last decade. The use of transient elastography in measuring liver stiffness has become the forefront of a wide range of noninvasive tools. Most of the other methods are based on measurements of biomarkers associated with fibrosis. There are several reasons for its wide acceptance, including the ease of performing a scan, the short procedure time, the results being immediately available on completion of the examination, and its reproducibility. For chronic hepatitis B (CHB), the cut-off values for F3 and F4 fibrosis range between 7.5-12.0 and 11.0-13.4 kPa, respectively, although the cut-offs may be slightly lower in those with normal ALT. In addition to measuring liver fibrosis, recent studies have demonstrated several other roles for transient elastography, including selecting patients who will benefit from antiviral therapy, monitoring response to antiviral therapy, and predicting long-term outcomes. However, there are limitations associated with transient elastography, including the confounding effects of inflammatory activity, and to a lesser extent, steatosis, on liver stiffness. There is also reduced accuracy observed in lower fibrosis stages (F0-F2). Furthermore, the incidences of failed and unreliable scan have been reported to be ~ 3 and 16%, respectively. Although liver biopsy can be avoided in an estimated 50-60% using transient elastography, in situations where liver stiffness measurement is nondiagnostic or inconsistent with the clinical picture, a biopsy is still recommended. Further studies are needed to consolidate the role of transient elastography in the management of CHB, and for incorporation of this method into current treatment guidelines. © 2011 The Author(s).
 
dc.description.naturepublished_or_final_version
 
dc.description.otherSpringer Open Choice, 21 Feb 2012
 
dc.identifier.citationHepatology International, 2011, v. 5 n. 4, p. 868-875 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s12072-011-9288-5
 
dc.identifier.citeulike9476932
 
dc.identifier.doihttp://dx.doi.org/10.1007/s12072-011-9288-5
 
dc.identifier.eissn1936-0541
 
dc.identifier.epage875
 
dc.identifier.hkuros211110
 
dc.identifier.isiWOS:000297133500002
 
dc.identifier.issn1936-0533
2013 Impact Factor: 2.468
 
dc.identifier.issue4
 
dc.identifier.pmcidPMC3215876
 
dc.identifier.pmid21695588
 
dc.identifier.scopuseid_2-s2.0-81855183204
 
dc.identifier.spage868
 
dc.identifier.urihttp://hdl.handle.net/10722/144890
 
dc.identifier.volume5
 
dc.languageeng
 
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0
 
dc.publisher.placeUnited States
 
dc.relation.ispartofHepatology International
 
dc.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.rightsThe original publication is available at www.springerlink.com
 
dc.subjectFibroscan
 
dc.subjectLiver fibrosis
 
dc.subjectNoninvasive
 
dc.titleThe use of transient elastography in the management of chronic hepatitis B
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong