Real Time Elastography in Patients with Chronic Hepatitis C: Assessment of Hepatic Fibrosis Using Liver Fibrosis Index

Background: Real time elastography (RTE) is a recent non-invasive method for hepatic fibrosis assessment. Multiple methods of quantitative evaluation using RTE have been proposed; yet, no sufficient studies are present to allow for its use in routine clinical practice. Aim: To assess the reliability of liver fibrosis index (LFI), as a new method of quantitative analysis of hepatic fibrosis in chronic hepatitis C patients. Patients and Methods: Sixty patients with chronic hepatitis C and scheduled for liver biopsy were enrolled. RTE was performed to all patients in addition to a group of twenty health volunteers. LFI measurements were compared to liver biopsy. Patients were also subjected to routine blood tests and conventional abdominal ultrasonography. Results: LFI highly correlated with the stage of hepatic fibrosis (r=0.746, p 0.001). LFI had high diagnostic accuracy for F≥3 (AUROC 0.96, sensitivity 94%, and specificity 93%), and for F≥2 (AUROC 0.93, sensitivity 84.6%, and specificity 85.4%), meanwhile it showed a lower accuracy for F≥1 (AUROC 0.87, sensitivity 83%, and specificity 71.4%). Conclusion: Real time elastography can be a reliable tool for hepatic fibrosis assessment in patients with chronic hepatitis C, being able to differentiate absence and mild fibrosis from advanced fibrosis and cirrhosis.