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American Gastroenterological Association Institute Technical Review on the Role of Elastography in Chronic Liver Diseases.

Publication ,  Journal Article
Singh, S; Muir, AJ; Dieterich, DT; Falck-Ytter, YT
Published in: Gastroenterology
May 2017

Chronic liver diseases (CLDs), due to chronic hepatitis C; hepatitis B; nonalcoholic fatty liver diseases (NAFLD); and alcoholic liver disease, are a leading cause of morbidity and mortality globally. Early identification of patients with cirrhosis at high risk of progression to liver-related complications may facilitate timely care and improve outcomes. With risks and misclassification associated with invasive tests, such as liver biopsy, noninvasive imaging modalities for liver fibrosis assessment have gained popularity. Therefore, the American Gastroenterological Association prioritized clinical guidelines on the role of elastography in CLDs, focusing on vibration-controlled transient elastography (VCTE) and magnetic resonance elastography (MRE). To inform these clinical guidelines, the current technical review was developed in accordance with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for diagnostic accuracy studies. This technical review addresses focused questions related to: (1) comparative diagnostic performance of VCTE and MRE relative to nonproprietary, serum-based fibrosis markers for detection of cirrhosis in patients with hepatitis C virus (HCV), hepatitis B virus (HBV), NAFLD, and alcoholic liver diseases; (2) performance of specific VCTE-defined liver stiffness cutoffs as a test replacement strategy (to replace liver biopsy) in making key decisions in the management of patients with CLDs; and (3) performance of specific VCTE-defined liver stiffness cutoffs as a triage test to identify patients with low likelihood of harboring high-risk esophageal varices (EVs) or having clinically significant portal hypertension (for presurgical risk stratification). This technical review does not address performance of other noninvasive modalities for assessing fibrosis (eg, acoustic radiation force pulse imaging or shear wave elastography) or steatosis (controlled attenuation parameter or magnetic resonance imaging-estimated proton density fat fraction).

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Published In

Gastroenterology

DOI

EISSN

1528-0012

Publication Date

May 2017

Volume

152

Issue

6

Start / End Page

1544 / 1577

Location

United States

Related Subject Headings

  • Risk Assessment
  • Non-alcoholic Fatty Liver Disease
  • Liver Diseases, Alcoholic
  • Liver Cirrhosis
  • Liver
  • Humans
  • Hepatitis C, Chronic
  • Hepatitis B, Chronic
  • Gastroenterology & Hepatology
  • Evidence-Based Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Singh, S., Muir, A. J., Dieterich, D. T., & Falck-Ytter, Y. T. (2017). American Gastroenterological Association Institute Technical Review on the Role of Elastography in Chronic Liver Diseases. Gastroenterology, 152(6), 1544–1577. https://doi.org/10.1053/j.gastro.2017.03.016
Singh, Siddharth, Andrew J. Muir, Douglas T. Dieterich, and Yngve T. Falck-Ytter. “American Gastroenterological Association Institute Technical Review on the Role of Elastography in Chronic Liver Diseases.Gastroenterology 152, no. 6 (May 2017): 1544–77. https://doi.org/10.1053/j.gastro.2017.03.016.
Singh S, Muir AJ, Dieterich DT, Falck-Ytter YT. American Gastroenterological Association Institute Technical Review on the Role of Elastography in Chronic Liver Diseases. Gastroenterology. 2017 May;152(6):1544–77.
Singh, Siddharth, et al. “American Gastroenterological Association Institute Technical Review on the Role of Elastography in Chronic Liver Diseases.Gastroenterology, vol. 152, no. 6, May 2017, pp. 1544–77. Pubmed, doi:10.1053/j.gastro.2017.03.016.
Singh S, Muir AJ, Dieterich DT, Falck-Ytter YT. American Gastroenterological Association Institute Technical Review on the Role of Elastography in Chronic Liver Diseases. Gastroenterology. 2017 May;152(6):1544–1577.
Journal cover image

Published In

Gastroenterology

DOI

EISSN

1528-0012

Publication Date

May 2017

Volume

152

Issue

6

Start / End Page

1544 / 1577

Location

United States

Related Subject Headings

  • Risk Assessment
  • Non-alcoholic Fatty Liver Disease
  • Liver Diseases, Alcoholic
  • Liver Cirrhosis
  • Liver
  • Humans
  • Hepatitis C, Chronic
  • Hepatitis B, Chronic
  • Gastroenterology & Hepatology
  • Evidence-Based Medicine