Dual elastography to discriminate adjacent stages of fibrosis and inflammation in chronic hepatitis B: A prospective multicenter study
Dou Jianping, Chen Xi, Cheng Guangwen, Meng Fankun, Zheng Ying, Zhang Bulin, Zhang Wei, Zhang Yao, Yin Zhiyong, Yang Hong, Lin Peng, Li Jiaping, Chen Zheng, Wei Shujing, Xu Xiting, Chen Chengcai, Chen Biwu, Huang Xuning, Fan Huiwen, Wu Jing, Zhu Jiabao, Xie Yuhuan, Lu Jingxin, Ding Hong, Yu Jie, Liang Ping- Hepatology
Background and aims:
To evaluate diagnostic performance of dual elastography (dual-elasto) in continuous differentiation of liver fibrosis and inflammation in a large prospective chronic hepatitis B (HBV) patient cohort.
Approach:
Adults with positive HBsAg for at least 6 months were recruited from 12 medical centers. Participants underwent dual-elasto evaluations. Biopsy was performed 3 days after dual-elasto examination. Four logistic regression models were trained and strung together into series models, Decision trees based on the series models were performed to achieve continuous differentiation of liver fibrosis and inflammation. Influence of inflammation on fibrosis stage was also evaluated.
Results:
560 patients were included in the training set and 240 in the validation set. Areas under the receiver operating characteristic curve (AUCs) of the series model were 0.82, 0.86, 0.93, and 0.96 to predict ≥ F1, ≥ F2, ≥F3 and F4 in the validation set, which were significantly higher than those of serum markers and shear wave elastography (all
Conclusions:
Dual elastography demonstrated high performance in the continuous discrimination of fibrosis and inflammation in HBV patients and could be used to diagnose mild fibrosis without influence of inflammation.