Vibration-controlled Transient Elastography in NAFLD: Review Study.

Area of Science:

• Hepatology
• Diagnostic Imaging
• Noninvasive Liver Assessment

Background:

• Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition with a broad clinical spectrum.
• NAFLD affects approximately one in four individuals globally, necessitating effective diagnostic tools.
• Vibration-controlled transient elastography (VCTE) has been utilized for two decades to assess liver steatosis and fibrosis.

Purpose of the Study:

• To review the diagnostic accuracy of transient elastography for liver steatosis and fibrosis.
• To provide information on the clinical application of transient elastography in NAFLD management.

Main Methods:

• Literature review of diagnostic accuracy studies on transient elastography (VCTE).
• Analysis of data on CAP score accuracy for steatosis detection (≥S1, ≥S2, ≥S3).
• Evaluation of elastography effectiveness for fibrosis staging (F≥2, F≥3, F≥4) in NAFLD patients.

Main Results:

• Transient elastography demonstrates high diagnostic accuracy for steatosis (AUC 0.8-0.95 for ≥S1) and fibrosis (AUC 0.79-0.99 for F≥2-F≥4).
• VCTE shows good sensitivity and specificity for detecting varying degrees of steatosis and fibrosis.
• A novel device, FibroTouch, shows correlation with FibroScan (r=0.5-0.6) for fibrosis detection (AUC ~0.8).

Conclusions:

• Transient elastography is a reliable noninvasive method for diagnosing NAFLD-related steatosis and fibrosis, with AUROC values generally exceeding 0.80.
• International guidelines recommend transient elastography for NAFLD diagnosis and guiding liver biopsy decisions.
• While FibroTouch shows promise, further research is needed to establish its interchangeability with FibroScan.