What is iqr in fibroscan

Any LSM that did not meet these criteria of reliability was excluded. LB specimens were fixed in formalin and paraffin-embedded.

Four-micrometer sections were stained with hematoxylin and eosin as well as Masson trichrome. All liver tissue samples were evaluated by an experienced hepatopathologist who was blinded to patients' clinical data and LSM results. LB specimens shorter than 15 mm were considered unsuitable for fibrosis assessment and were excluded from analysis. Liver histology was evaluated semiquantitatively using the Batts and Ludwig 15 scoring system. After establishing a minimal number of VMs required for a reliable LSM, we aimed to identify predictors of discordance in fibrosis stage as estimated by the median elasticity score, which was based on the minimal VM requirement, and by LB.

Therefore, we sought external reference cutoff values for LSM from the literature. We found three meta-analyses on LSM. Since the article by Chan, et al. For patients with CHC, Stebbing, et al. Furthermore, the cutoff values in their analysis may potentially be biased with the preponderance of patients with high BMI in the studies included.

We eventually used the cutoff values presented by Nitta, et al. Binary logistic regression analysis was used to identify predictors of discordance in fibrosis stages as estimated by the median elasticity score from the identified minimal number of VMs and by LB. A two-sided p value of less than 0. All statistical computations were performed with SPSS software version The baseline characteristics of all patients are presented in Table 1.

The median age of our study population with CHC was slightly lower than that of a previous study by Nitta, et al. The baseline LSM data are summarized in Table 2. The mean number of VMs acquired was Distributions of fibrosis stage, activity grade, and steatosis are listed in Table 3. Only two 1. The median LSM values and ranges according to fibrosis stages are shown in Fig. The median LSM value was 5. In those with CHC, it was 4. Table 4 and Fig.

VMs, valid measurements. AUROC, area under the receiver operating characteristic curve. Using the LSM cutoff values from Chan, et al. Using the cutoff values from Nitta, et al. Investigators therefore have questioned their validity and influences on LSM accuracy. These newly proposed and more stringent criteria of Lucidarme, et al.

As a result, valid LSM results might have continually been discarded because of the overestimated standard number of VMs required for reliability of LSM. Thus, it is imperative to set the optimal number of VMs. Fortunately, Kettaneh, et al. From this study, they concluded that setting the number of VMs at 5 or more will extend the benefits from LSM to more European patients with CHC without significant loss of diagnostic accuracy. Furthermore, different prevalence in obesity and metabolic syndrome between Asian and Western populations as well as different viral characteristics between CHB and CHC may significantly influence LSM results.

In contrast to previous studies, we found that LSM predicted cirrhosis less accurately than it did significant fibrosis in patients with CHB. In common with a previous study, 9 we found that the accuracy of LSM in predicting significant fibrosis and cirrhosis using median elasticity scores from the first 3, first 5, and all VMs taken was similar in both patients with CHB and those with CHC.

From this, we decided that 3 VMs of LSM may suffice in assessing liver fibrosis without significant loss of accuracy and then tried to identify factors that predict discordance in fibrosis stage estimates, according to the median elasticity score from the first 3 VMs and LB.

The overall discordance in our study population was Although our overall discordance agreed with that in a previous study by Lucidarme, et al. In contrast, we found no significant predictor of discordance in patients with CHC.

Using the median elasticity scores from the first 3 VMs and LB, we calculated the optimal ALT cutoff level, which maximally distinguished patients with non-discordance from those with discordance between LSM and LB, as 1. This value is very close to those in previous studies 1. The prevalence of discordance was 9.

As in Kettaneh, et al. This approach was unavoidable; however, as only 9 3. Indeed, a sufficient number of patients with fewer than 10 VMs should be assembled to identify baseline factors for predicting those who would or would not obtain more than 10 VMs, by comparing their baseline characteristics before LSM examinations.

Knowledge of these baseline predictors will allow us to decide when to stop measuring further unnecessary measurements of liver elasticity, allowing us to use only the minimal, but sufficient number of VMs for each patient. Furthermore, doing so will eventually clarify whether a reduced number of VMs of less than 10 can be adopted for analyzing the performance of LSM in an adequate study group with less than 10 VMs available. In our study, a small number of patients with than 10 VMs is one of our main limitations.

A larger study, possibly a multi-center trial, including patients with a strategic balance of VMs should be performed to justify our findings. In addition, the small sample size overall, especially for patients with CHC, is another limitation of our study. Finally, we used external studies on the performance of LSM in Asian patients as reference cutoff values. Therefore, results of this study might be not relevant for Europeans.

The authors have no financial conflicts of interest. National Center for Biotechnology Information , U. Journal List Yonsei Med J v. Yonsei Med J. Published online Jan Find articles by Hui Won Jang. Find articles by Seung Up Kim.

Find articles by Jun Yong Park. Find articles by Sang Hoon Ahn. Find articles by Kwang-Hyub Han. Find articles by Chae Yoon Chon. Find articles by Young Nyun Park. Find articles by Eun Hee Choi. Find articles by Do Young Kim. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Corresponding author: Dr. Tel: , Fax: , ca. This article has been cited by other articles in PMC. The ranges of fibrosis results in the table are estimates.

This means that your actual fibrosis score the score that your healthcare provider tells you may not match the fibrosis score in the table. If you have more than one liver disease, you may not be able to use the table. To use the table, find the liver disease that you have on the left side of the table. Read across the row from left to right until you find the range that includes your fibrosis result. Then, look at the top of that column to see the fibrosis score.

Your fibrosis result may be over-estimated your liver may have less scarring than what your fibrosis result says if you have:. Your feedback will help us improve the information we provide to patients and caregivers. We read every comment, but we're not able to respond. If you have questions about your care, contact your healthcare provider. For more resources, visit www. You must have JavaScript enabled to use this form. Tell us what you think Your feedback will help us improve the information we provide to patients and caregivers.

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