Suboptimal diagnostic accuracy of ultrasound and CT for compensated cirrhosis: Evidence from prospective cohort studies
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Suboptimal diagnostic accuracy of ultrasound and CT for compensated cirrhosis : Evidence from prospective cohort studies. / Hetland, Liv E; Kronborg, Thit M.; Thing, Mira; Werge, Mikkel P; Junker, Anders E; Rashu, Elias B; O'Connell, Malene B.; Olsen, Beth H; Jensen, Anne-Sofie H; Wewer Albrechtsen, Nicolai J; Møller, Søren; Hobolth, Lise; Mortensen, Christian; Kimer, Nina; Gluud, Lise Lotte.
I: Hepatology Communications, Bind 7, Nr. 9, e0231, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Suboptimal diagnostic accuracy of ultrasound and CT for compensated cirrhosis
T2 - Evidence from prospective cohort studies
AU - Hetland, Liv E
AU - Kronborg, Thit M.
AU - Thing, Mira
AU - Werge, Mikkel P
AU - Junker, Anders E
AU - Rashu, Elias B
AU - O'Connell, Malene B.
AU - Olsen, Beth H
AU - Jensen, Anne-Sofie H
AU - Wewer Albrechtsen, Nicolai J
AU - Møller, Søren
AU - Hobolth, Lise
AU - Mortensen, Christian
AU - Kimer, Nina
AU - Gluud, Lise Lotte
N1 - Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.
PY - 2023
Y1 - 2023
N2 - INTRODUCTION: Abdominal ultrasound (US) and CT are important tools for the initial evaluation of patients with liver disease. Our study aimed to determine the accuracy of these methods for diagnosing cirrhosis.METHODS: In all, 377 participants from 4 prospective cohort studies evaluating patients with various liver diseases were included. All patients were included between 2017 and 2022 and had undergone a liver biopsy as well as US and/or CT. Using the histological assessment as the gold standard, we calculated diagnostic accuracy for US and CT. Liver biopsies were evaluated by expert histopathologists and diagnostic scans by experienced radiologists.RESULTS: The mean age was 54 ± 14 years and 47% were female. Most patients had NAFLD (58.3%) or alcohol-associated liver disease (25.5%). The liver biopsy showed cirrhosis in 147 patients (39.0%). Eighty-three patients with cirrhosis had Child-Pugh A (56.4% of patients with cirrhosis) and 64 had Child-Pugh B/C (43.6%). Overall, the sensitivity for diagnosing cirrhosis by US was 0.71 (95% CI 0.62-0.79) and for CT 0.74 (95% CI 0.64-0.83). The specificity was high for US (0.94, 95% CI 0.90-0.97) and for CT (0.93, 95% CI 0.83-0.98). When evaluating patients with Child-Pugh A cirrhosis, sensitivity was only 0.62 (95% CI 0.49-0.74) for US and 0.60 (95% CI 0.43-0.75) for CT. For patients with Child-Pugh B/C, sensitivity was 0.83 (95% CI 0.70-0.92) for US and 0.87 (95% CI 0.74-0.95) for CT. When limiting our analysis to NAFLD (20% with cirrhosis), the sensitivity for US was 0.45 (95% CI 0.28-0.64) and specificity was 0.97 (95% CI 0.93-0.99).CONCLUSION: US and CT show moderate sensitivity and may potentially overlook compensated cirrhosis underlining the need for additional diagnostic testing.
AB - INTRODUCTION: Abdominal ultrasound (US) and CT are important tools for the initial evaluation of patients with liver disease. Our study aimed to determine the accuracy of these methods for diagnosing cirrhosis.METHODS: In all, 377 participants from 4 prospective cohort studies evaluating patients with various liver diseases were included. All patients were included between 2017 and 2022 and had undergone a liver biopsy as well as US and/or CT. Using the histological assessment as the gold standard, we calculated diagnostic accuracy for US and CT. Liver biopsies were evaluated by expert histopathologists and diagnostic scans by experienced radiologists.RESULTS: The mean age was 54 ± 14 years and 47% were female. Most patients had NAFLD (58.3%) or alcohol-associated liver disease (25.5%). The liver biopsy showed cirrhosis in 147 patients (39.0%). Eighty-three patients with cirrhosis had Child-Pugh A (56.4% of patients with cirrhosis) and 64 had Child-Pugh B/C (43.6%). Overall, the sensitivity for diagnosing cirrhosis by US was 0.71 (95% CI 0.62-0.79) and for CT 0.74 (95% CI 0.64-0.83). The specificity was high for US (0.94, 95% CI 0.90-0.97) and for CT (0.93, 95% CI 0.83-0.98). When evaluating patients with Child-Pugh A cirrhosis, sensitivity was only 0.62 (95% CI 0.49-0.74) for US and 0.60 (95% CI 0.43-0.75) for CT. For patients with Child-Pugh B/C, sensitivity was 0.83 (95% CI 0.70-0.92) for US and 0.87 (95% CI 0.74-0.95) for CT. When limiting our analysis to NAFLD (20% with cirrhosis), the sensitivity for US was 0.45 (95% CI 0.28-0.64) and specificity was 0.97 (95% CI 0.93-0.99).CONCLUSION: US and CT show moderate sensitivity and may potentially overlook compensated cirrhosis underlining the need for additional diagnostic testing.
KW - Humans
KW - Female
KW - Adult
KW - Middle Aged
KW - Aged
KW - Male
KW - Non-alcoholic Fatty Liver Disease/diagnostic imaging
KW - Prospective Studies
KW - Liver Cirrhosis/diagnostic imaging
KW - Ultrasonography
KW - Liver Diseases, Alcoholic
KW - Tomography, X-Ray Computed
U2 - 10.1097/HC9.0000000000000231
DO - 10.1097/HC9.0000000000000231
M3 - Journal article
C2 - 37655978
VL - 7
JO - Hepatology Communications
JF - Hepatology Communications
SN - 2471-254X
IS - 9
M1 - e0231
ER -
ID: 367837483