Fibroscan® in hepatology: a clinically-validated tool using vibration-controlled transient elastography

Vibration-Controlled Transient Elastography (VCTE^¿) based Fibroscan^® (Echosens, Paris, France) is more and more used in clinical practice for the staging of liver fibrosis. Fibroscan^® offers a rapid, simple, non-invasive and reliable means to quantify liver stiffness (LS). The most complete meta-analysis reported a strong correlation between liver fibrosis stage obtained by liver biopsy and LS. Area under the receiver operating curve (AUROC) for the diagnosis of significant fibrosis and cirrhosis are close to 0.84 and 0.94, respectively. However other factors may affect LS. We report here the effect of intravenous pressure that was studied in landrace pigs. Pig LS measurements were performed with increasing intravenous hydrostatic pressure up to 50 cm water. LS increases from 4.9 kPa before clamping to the maximum measurement value 75 kPa for hydrostatic pressure superior to 36 cm water. LS is directly influenced by intravenous pressure. Other studies reported that LS is also correlated to necrosis and inflammatory activity in patients suffering from chronic liver diseases. As a conclusion many disease related factors affect LS which emphasizes the role of LS measured by Fibroscan^® as a key parameter for the diagnosis of liver health status.