Guided-VCTE: An Enhanced FibroScan Examination With Improved Guidance and Applicability.

Area of Science:

• Hepatology
• Medical Imaging
• Diagnostic Technology

Background:

• FibroScan (FS), utilizing Vibration-Controlled Transient Elastography (VCTE), is standard for non-invasive liver fibrosis and steatosis assessment.
• Standard VCTE examinations present challenges in terms of time and success rates for patients with obesity.
• Obesity can impede accurate shear wave propagation and signal acquisition during VCTE assessments.

Purpose of the Study:

• To evaluate the effectiveness of a novel Guided-VCTE indicator for assessing liver stiffness measurements (LSM).
• To compare examination times and success rates between standard VCTE and Guided-VCTE.
• To determine the utility of Guided-VCTE in patients with varying Body Mass Index (BMI), particularly those with obesity.

Main Methods:

• A multicenter study involving 130 patients with diverse BMIs.
• Assessment of the new indicator's effectiveness using sensitivity, specificity, positive predictive values, and negative predictive values.
• Comparison of success rates and examination times using Wilcoxon signed rank tests and time-to-event analyses.

Main Results:

• The new indicator demonstrated high effectiveness with 97% sensitivity for predicting valid LSM.
• Guided-VCTE significantly improved measurement success rates and reduced liver localization time, especially in patients with Grade 2 obesity (BMI ≥35 kg/m²).
• A higher proportion of patients were scanned in under 4 minutes using Guided-VCTE compared to standard VCTE.

Conclusions:

• Guided-VCTE is an effective new technique that simplifies FibroScan use.
• This method is particularly beneficial for improving VCTE assessments in patients with obesity.
• Guided-VCTE enhances the efficiency and accuracy of non-invasive liver assessment in challenging patient populations.