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Controlled Attenuation Parameter (CAP): a noninvasive method for the detection of hepatic steatosis based on transient elastography
Background Accurate tools for the noninvasive detection of hepatic steatosis are needed. The Controlled Attenuation Parameter (CAP) specifically targets liver steatosis using a process based on transient elastography. Methods Patients with chronic liver disease and body mass index (BMI) ≥28 kg/m2 un...
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| Published in: | Liver international 2012-07, Vol.32 (6), p.902-910 |
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| Main Authors: | , , , , , , , , , |
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| container_end_page | 910 |
| container_issue | 6 |
| container_start_page | 902 |
| container_title | Liver international |
| container_volume | 32 |
| creator | Myers, Robert P. Pollett, Aaron Kirsch, Richard Pomier-Layrargues, Gilles Beaton, Melanie Levstik, Mark Duarte-Rojo, Andres Wong, David Crotty, Pam Elkashab, Magdy |
| description | Background
Accurate tools for the noninvasive detection of hepatic steatosis are needed. The Controlled Attenuation Parameter (CAP) specifically targets liver steatosis using a process based on transient elastography.
Methods
Patients with chronic liver disease and body mass index (BMI) ≥28 kg/m2 underwent biopsy and liver stiffness measurement (LSM) with simultaneous CAP determination using the FibroScan® M probe. The performance of the CAP for diagnosing steatosis compared with biopsy was assessed using areas under receiver operating characteristic curves (AUROC).
Results
A total of 153 patients were included: 69% were male, median BMI was 32 kg/m2; 47% had nonalcoholic fatty liver disease (NAFLD); and 65% had significant (≥10%) steatosis. The CAP was significantly correlated with the percentage of steatosis (ρ = 0.47) and steatosis grade (ρ = 0.51; both P |
| doi_str_mv | 10.1111/j.1478-3231.2012.02781.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1019620157</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1019620157</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4731-93edc62a7c4b58dfe57cfb16497e8a4adfa42d338ebee0ad9898c3f82e4ca93c3</originalsourceid><addsrcrecordid>eNqNkUtv2zAQhImiRZOm_QsFj-lBikhKIlWgB8NoHoDRBkEfR2JFrWq5MumQdGqf-8dDxanP5YULzDezwCwhlBU5S-9ilbNSqkxwwXJeMJ4XXCqW716Q06Pw8jhzcULehLAqCtY0FXtNTjgvRSVrdkr-zp2N3o0jdnQWI9otxMFZegse1hjR0_P57PbDRwrUOjvYBwjDA9IkLV1He-dpXCLtEmmefK6nS9ykDENDRIguDIG2EFJ8UqMHGwa0keIIIbpfHjbL_Vvyqocx4Lvn_4x8v_z8bX6dLb5e3cxni8yUUrCsEdiZmoM0ZVuprsdKmr5lddlIVFBC10PJOyEUtogFdI1qlBG94lgaaIQRZ-T8kLvx7n6LIer1EAyOI1h026BZ6qdOdVYyoeqAGu9C8NjrjR_W4PcJ0tMJ9EpP7eqpaT2dQD-dQO-S9f3zlm27xu5o_Nd5Aj4dgD_DiPv_DtaLmx_TlPzZwT-khndHP_jfupZCVvrnlytdssvr4o7X-k48Atmbptg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1019620157</pqid></control><display><type>article</type><title>Controlled Attenuation Parameter (CAP): a noninvasive method for the detection of hepatic steatosis based on transient elastography</title><source>Wiley</source><creator>Myers, Robert P. ; Pollett, Aaron ; Kirsch, Richard ; Pomier-Layrargues, Gilles ; Beaton, Melanie ; Levstik, Mark ; Duarte-Rojo, Andres ; Wong, David ; Crotty, Pam ; Elkashab, Magdy</creator><creatorcontrib>Myers, Robert P. ; Pollett, Aaron ; Kirsch, Richard ; Pomier-Layrargues, Gilles ; Beaton, Melanie ; Levstik, Mark ; Duarte-Rojo, Andres ; Wong, David ; Crotty, Pam ; Elkashab, Magdy</creatorcontrib><description>Background
Accurate tools for the noninvasive detection of hepatic steatosis are needed. The Controlled Attenuation Parameter (CAP) specifically targets liver steatosis using a process based on transient elastography.
Methods
Patients with chronic liver disease and body mass index (BMI) ≥28 kg/m2 underwent biopsy and liver stiffness measurement (LSM) with simultaneous CAP determination using the FibroScan® M probe. The performance of the CAP for diagnosing steatosis compared with biopsy was assessed using areas under receiver operating characteristic curves (AUROC).
Results
A total of 153 patients were included: 69% were male, median BMI was 32 kg/m2; 47% had nonalcoholic fatty liver disease (NAFLD); and 65% had significant (≥10%) steatosis. The CAP was significantly correlated with the percentage of steatosis (ρ = 0.47) and steatosis grade (ρ = 0.51; both P < 0.00005). The median CAP was higher among patients with significant steatosis (317 [IQR 284–339] vs. 250 [227–279] dB/m with <10% steatosis; P < 0.0005) and the AUROC for this outcome was 0.81 (95% CI 0.74–0.88). At a cut‐off of 283 dB/m, the CAP was 76% sensitive, 79% specific, and had positive and negative predictive values of 87% and 64%, respectively. CAP performance was not influenced by measurement variability, but was higher in patients with mild (F0‐F1) fibrosis (AUROC 0.89 vs. 0.72 with F2‐F4; P = 0.03). The AUROCs of the CAP for ≥5%, >33% and >66% steatosis were 0.79, 0.76 and 0.70, respectively.
Conclusions
The CAP is a promising tool for the noninvasive detection of hepatic steatosis. Advantages of CAP include its ease of measurement, operator‐independence and simultaneous availability with LSM for fibrosis assessment.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/j.1478-3231.2012.02781.x</identifier><identifier>PMID: 22435761</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Biopsy ; Body Mass Index ; Chi-Square Distribution ; Chronic Disease ; Elasticity Imaging Techniques ; elastography ; fatty liver ; Fatty Liver - diagnosis ; Fatty Liver - diagnostic imaging ; Fatty Liver - pathology ; Female ; Humans ; Liver - diagnostic imaging ; Liver - pathology ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - diagnostic imaging ; Liver Cirrhosis - pathology ; Male ; Middle Aged ; Multivariate Analysis ; Non-alcoholic Fatty Liver Disease ; Ontario ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; ROC Curve ; Sensitivity and Specificity ; Severity of Illness Index ; steatosis</subject><ispartof>Liver international, 2012-07, Vol.32 (6), p.902-910</ispartof><rights>2012 John Wiley & Sons A/S</rights><rights>2012 John Wiley & Sons A/S.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4731-93edc62a7c4b58dfe57cfb16497e8a4adfa42d338ebee0ad9898c3f82e4ca93c3</citedby><cites>FETCH-LOGICAL-c4731-93edc62a7c4b58dfe57cfb16497e8a4adfa42d338ebee0ad9898c3f82e4ca93c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22435761$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Myers, Robert P.</creatorcontrib><creatorcontrib>Pollett, Aaron</creatorcontrib><creatorcontrib>Kirsch, Richard</creatorcontrib><creatorcontrib>Pomier-Layrargues, Gilles</creatorcontrib><creatorcontrib>Beaton, Melanie</creatorcontrib><creatorcontrib>Levstik, Mark</creatorcontrib><creatorcontrib>Duarte-Rojo, Andres</creatorcontrib><creatorcontrib>Wong, David</creatorcontrib><creatorcontrib>Crotty, Pam</creatorcontrib><creatorcontrib>Elkashab, Magdy</creatorcontrib><title>Controlled Attenuation Parameter (CAP): a noninvasive method for the detection of hepatic steatosis based on transient elastography</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>Background
Accurate tools for the noninvasive detection of hepatic steatosis are needed. The Controlled Attenuation Parameter (CAP) specifically targets liver steatosis using a process based on transient elastography.
Methods
Patients with chronic liver disease and body mass index (BMI) ≥28 kg/m2 underwent biopsy and liver stiffness measurement (LSM) with simultaneous CAP determination using the FibroScan® M probe. The performance of the CAP for diagnosing steatosis compared with biopsy was assessed using areas under receiver operating characteristic curves (AUROC).
Results
A total of 153 patients were included: 69% were male, median BMI was 32 kg/m2; 47% had nonalcoholic fatty liver disease (NAFLD); and 65% had significant (≥10%) steatosis. The CAP was significantly correlated with the percentage of steatosis (ρ = 0.47) and steatosis grade (ρ = 0.51; both P < 0.00005). The median CAP was higher among patients with significant steatosis (317 [IQR 284–339] vs. 250 [227–279] dB/m with <10% steatosis; P < 0.0005) and the AUROC for this outcome was 0.81 (95% CI 0.74–0.88). At a cut‐off of 283 dB/m, the CAP was 76% sensitive, 79% specific, and had positive and negative predictive values of 87% and 64%, respectively. CAP performance was not influenced by measurement variability, but was higher in patients with mild (F0‐F1) fibrosis (AUROC 0.89 vs. 0.72 with F2‐F4; P = 0.03). The AUROCs of the CAP for ≥5%, >33% and >66% steatosis were 0.79, 0.76 and 0.70, respectively.
Conclusions
The CAP is a promising tool for the noninvasive detection of hepatic steatosis. Advantages of CAP include its ease of measurement, operator‐independence and simultaneous availability with LSM for fibrosis assessment.</description><subject>Adult</subject><subject>Biopsy</subject><subject>Body Mass Index</subject><subject>Chi-Square Distribution</subject><subject>Chronic Disease</subject><subject>Elasticity Imaging Techniques</subject><subject>elastography</subject><subject>fatty liver</subject><subject>Fatty Liver - diagnosis</subject><subject>Fatty Liver - diagnostic imaging</subject><subject>Fatty Liver - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Liver - diagnostic imaging</subject><subject>Liver - pathology</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - diagnostic imaging</subject><subject>Liver Cirrhosis - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Non-alcoholic Fatty Liver Disease</subject><subject>Ontario</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>steatosis</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNkUtv2zAQhImiRZOm_QsFj-lBikhKIlWgB8NoHoDRBkEfR2JFrWq5MumQdGqf-8dDxanP5YULzDezwCwhlBU5S-9ilbNSqkxwwXJeMJ4XXCqW716Q06Pw8jhzcULehLAqCtY0FXtNTjgvRSVrdkr-zp2N3o0jdnQWI9otxMFZegse1hjR0_P57PbDRwrUOjvYBwjDA9IkLV1He-dpXCLtEmmefK6nS9ykDENDRIguDIG2EFJ8UqMHGwa0keIIIbpfHjbL_Vvyqocx4Lvn_4x8v_z8bX6dLb5e3cxni8yUUrCsEdiZmoM0ZVuprsdKmr5lddlIVFBC10PJOyEUtogFdI1qlBG94lgaaIQRZ-T8kLvx7n6LIer1EAyOI1h026BZ6qdOdVYyoeqAGu9C8NjrjR_W4PcJ0tMJ9EpP7eqpaT2dQD-dQO-S9f3zlm27xu5o_Nd5Aj4dgD_DiPv_DtaLmx_TlPzZwT-khndHP_jfupZCVvrnlytdssvr4o7X-k48Atmbptg</recordid><startdate>201207</startdate><enddate>201207</enddate><creator>Myers, Robert P.</creator><creator>Pollett, Aaron</creator><creator>Kirsch, Richard</creator><creator>Pomier-Layrargues, Gilles</creator><creator>Beaton, Melanie</creator><creator>Levstik, Mark</creator><creator>Duarte-Rojo, Andres</creator><creator>Wong, David</creator><creator>Crotty, Pam</creator><creator>Elkashab, Magdy</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201207</creationdate><title>Controlled Attenuation Parameter (CAP): a noninvasive method for the detection of hepatic steatosis based on transient elastography</title><author>Myers, Robert P. ; Pollett, Aaron ; Kirsch, Richard ; Pomier-Layrargues, Gilles ; Beaton, Melanie ; Levstik, Mark ; Duarte-Rojo, Andres ; Wong, David ; Crotty, Pam ; Elkashab, Magdy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4731-93edc62a7c4b58dfe57cfb16497e8a4adfa42d338ebee0ad9898c3f82e4ca93c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Biopsy</topic><topic>Body Mass Index</topic><topic>Chi-Square Distribution</topic><topic>Chronic Disease</topic><topic>Elasticity Imaging Techniques</topic><topic>elastography</topic><topic>fatty liver</topic><topic>Fatty Liver - diagnosis</topic><topic>Fatty Liver - diagnostic imaging</topic><topic>Fatty Liver - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Liver - diagnostic imaging</topic><topic>Liver - pathology</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - diagnostic imaging</topic><topic>Liver Cirrhosis - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Non-alcoholic Fatty Liver Disease</topic><topic>Ontario</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>steatosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Myers, Robert P.</creatorcontrib><creatorcontrib>Pollett, Aaron</creatorcontrib><creatorcontrib>Kirsch, Richard</creatorcontrib><creatorcontrib>Pomier-Layrargues, Gilles</creatorcontrib><creatorcontrib>Beaton, Melanie</creatorcontrib><creatorcontrib>Levstik, Mark</creatorcontrib><creatorcontrib>Duarte-Rojo, Andres</creatorcontrib><creatorcontrib>Wong, David</creatorcontrib><creatorcontrib>Crotty, Pam</creatorcontrib><creatorcontrib>Elkashab, Magdy</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Myers, Robert P.</au><au>Pollett, Aaron</au><au>Kirsch, Richard</au><au>Pomier-Layrargues, Gilles</au><au>Beaton, Melanie</au><au>Levstik, Mark</au><au>Duarte-Rojo, Andres</au><au>Wong, David</au><au>Crotty, Pam</au><au>Elkashab, Magdy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Controlled Attenuation Parameter (CAP): a noninvasive method for the detection of hepatic steatosis based on transient elastography</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2012-07</date><risdate>2012</risdate><volume>32</volume><issue>6</issue><spage>902</spage><epage>910</epage><pages>902-910</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background
Accurate tools for the noninvasive detection of hepatic steatosis are needed. The Controlled Attenuation Parameter (CAP) specifically targets liver steatosis using a process based on transient elastography.
Methods
Patients with chronic liver disease and body mass index (BMI) ≥28 kg/m2 underwent biopsy and liver stiffness measurement (LSM) with simultaneous CAP determination using the FibroScan® M probe. The performance of the CAP for diagnosing steatosis compared with biopsy was assessed using areas under receiver operating characteristic curves (AUROC).
Results
A total of 153 patients were included: 69% were male, median BMI was 32 kg/m2; 47% had nonalcoholic fatty liver disease (NAFLD); and 65% had significant (≥10%) steatosis. The CAP was significantly correlated with the percentage of steatosis (ρ = 0.47) and steatosis grade (ρ = 0.51; both P < 0.00005). The median CAP was higher among patients with significant steatosis (317 [IQR 284–339] vs. 250 [227–279] dB/m with <10% steatosis; P < 0.0005) and the AUROC for this outcome was 0.81 (95% CI 0.74–0.88). At a cut‐off of 283 dB/m, the CAP was 76% sensitive, 79% specific, and had positive and negative predictive values of 87% and 64%, respectively. CAP performance was not influenced by measurement variability, but was higher in patients with mild (F0‐F1) fibrosis (AUROC 0.89 vs. 0.72 with F2‐F4; P = 0.03). The AUROCs of the CAP for ≥5%, >33% and >66% steatosis were 0.79, 0.76 and 0.70, respectively.
Conclusions
The CAP is a promising tool for the noninvasive detection of hepatic steatosis. Advantages of CAP include its ease of measurement, operator‐independence and simultaneous availability with LSM for fibrosis assessment.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>22435761</pmid><doi>10.1111/j.1478-3231.2012.02781.x</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Biopsy Body Mass Index Chi-Square Distribution Chronic Disease Elasticity Imaging Techniques elastography fatty liver Fatty Liver - diagnosis Fatty Liver - diagnostic imaging Fatty Liver - pathology Female Humans Liver - diagnostic imaging Liver - pathology Liver Cirrhosis - diagnosis Liver Cirrhosis - diagnostic imaging Liver Cirrhosis - pathology Male Middle Aged Multivariate Analysis Non-alcoholic Fatty Liver Disease Ontario Predictive Value of Tests Prospective Studies Reproducibility of Results ROC Curve Sensitivity and Specificity Severity of Illness Index steatosis |
| title | Controlled Attenuation Parameter (CAP): a noninvasive method for the detection of hepatic steatosis based on transient elastography |
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