ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2010 - Poster Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress/PublishingImages/top_ei.jpg" width="760" height="129" /></td> </tr> <tr> <td class="content"><h1>Poster Presentations</h1> <P><b>Session Title:</b> Category 9. ELASTOGRAPHY / LIVER STIFFNESS<br><b>Presentation Date:</b> Apr 15, 2010</P><h2 align='left'><B>GOLD-VALIDATION OF LIVER FIBROSIS ESTIMATES, FIBROTEST (FT) AND LIVER STIFFNESS MEASUREMENT (LSM), USING SURGICAL SAMPLES AND VIRTUAL BIOPSIES</B></h2> <p align='left'><b>T. Poynard</b><sup>1</sup>*, G. Lenaour<sup>1</sup>, F. Charlotte<sup>1</sup>, M. Munteanu<sup>2</sup>, J.C. Vaillant<sup>1</sup>, Y. Ngo<sup>2</sup>, V. Ratziu<sup>1</sup>, L. Hannoun<sup>1</sup>, F. Capron<sup>1</sup><br> <em><sup>1</sup>UPMC APHP Paris Liver Center, <sup>2</sup>Biopredictive, Paris, France. *thierry@poynard.com</em></p><br> <p align='justify'><b><b>Background: </b></b> Fibrosis biomarkers FT and LSM (Fibroscan®) have been validated using biopsy as a reference. In HCV, when compared to large surgical samples (perfect reference), 25% of biopsies (25mm) were categorized incorrectly (Bedossa 2003). Therefore the true quantitative correlations of FT and LSM with fibrosis area (FA) are unknown. <br> <b><b>Aim: </b></b> To better estimate FT and LSM performances, we assessed the strength of concordance between FT and LSM with FA of surgical samples, according to biopsy length.<br> <b><b>Methods: </b></b> Surgical samples, FT and LSM, from 12 consecutive patients with chronic liver diseases and 4 controls, were prospectively studied. From the digitized image (Aperio Scanner, TRIBVN, France), 22,119 virtual biopsies of increasing length (5/10/15/20/25/30mm) were produced: 5,106 HCV, 4,572 ALD, 3,240 NAFLD, 3,988 HBV, 1,458 PBC and 4,665 controls. The concordance of FT and LSM with FA was assessed using the Spearman correlation coefficient (S), and R2 of best curve fitting. <br> <b><b>Results: </b></b> FA reference values were 3.8% (4 subjects METAVIR stage F0), 5.0% (1 F1), 7.1% (3 F2), 9.0% (1 F3) and 18.2% (7 F4) similar to those previously described in HCV. In all liver diseases the coefficient of variation decreased with biopsy length from 0.87 (5mm) to 0.69 (30mm) biopsy. FT ranged from 0.13 to 0.98 and LSM from 3.7 to 23.8 kPa. For FT and LSM there was a steady increase in concordance with FA according to biopsy length: FT from 5mm S=0.68 (95%CI 0.66-0.70) to 30mm S=0.78 (0.76-0.79); FS from 5mm S=0.60 (0.57-0.62) to 30mm S=0.65 (0.62-0.67). Differences between S were significant between biopsy lengths (p< 0.05) for FT and not for LSM. For FT the best curves fitting was obtained using linear association after logarithmic transformation of FA; R2 steadily increased from 0.51 to 0.69. For LSM the best fitting was obtained using linear association after logarithmic transformation of both FA and LSM; R2 increased from 0.35 to 0.49. S and R2 were all significantly higher for FT vs. LSM (P< 0.01). <br> <b><b>Conclusion: </b></b> Both FT and LSM strength of concordance with area of fibrosis increased with length of biopsy, with a significantly higher association for FT than LSM.</p> <br><a href='Session-P01-9.htm'>Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>