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Article: The use of transient elastography in the management of chronic hepatitis B

TitleThe use of transient elastography in the management of chronic hepatitis B
Authors
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
Citation
Hepatology International, 2011, v. 5 n. 4, p. 868-875 How to Cite?
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).
Persistent Identifierhttp://hdl.handle.net/10722/144890
ISSN
2014 Impact Factor: 1.780
2014 SCImago Journal Rankings: 0.609
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFung, Jen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorSeto, WKen_HK
dc.contributor.authorYuen, MFen_HK
dc.date.accessioned2012-02-21T05:44:22Z-
dc.date.available2012-02-21T05:44:22Z-
dc.date.issued2011en_HK
dc.identifier.citationHepatology International, 2011, v. 5 n. 4, p. 868-875en_HK
dc.identifier.issn1936-0533en_HK
dc.identifier.urihttp://hdl.handle.net/10722/144890-
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).en_HK
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0en_HK
dc.relation.ispartofHepatology Internationalen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_US
dc.rightsThe original publication is available at www.springerlink.comen_US
dc.subjectFibroscanen_HK
dc.subjectLiver fibrosisen_HK
dc.subjectNoninvasiveen_HK
dc.titleThe use of transient elastography in the management of chronic hepatitis Ben_HK
dc.typeArticleen_HK
dc.identifier.emailFung, J: jfung@sicklehut.comen_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailSeto, WK: wkseto2@hku.hken_HK
dc.identifier.emailYuen, MF: mfyuen@hku.hken_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authoritySeto, WK=rp01659en_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1007/s12072-011-9288-5en_HK
dc.identifier.pmid21695588-
dc.identifier.pmcidPMC3215876-
dc.identifier.scopuseid_2-s2.0-81855183204en_HK
dc.identifier.hkuros211110-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-81855183204&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume5en_HK
dc.identifier.issue4en_HK
dc.identifier.spage868en_HK
dc.identifier.epage875en_HK
dc.identifier.eissn1936-0541en_US
dc.identifier.isiWOS:000297133500002-
dc.publisher.placeUnited Statesen_HK
dc.description.otherSpringer Open Choice, 21 Feb 2012en_US
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridSeto, WK=23390675900en_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK
dc.identifier.citeulike9476932-

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