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TitleTransient elastography: should XL probe be used in all overweight patients?
Author(s)Arieira, Cátia
Monteiro, Sara
Xavier, Sofia
Castro, Francisca Dias de
Magalhães, Joana Fernandes Silva
Marinho, Carla
Pinto, Rui
Costa, Washington
Correia, José Pinto
Cotter, José Almeida Berkeley
Body Mass Index
Elasticity Imaging Techniques
Equipment Design
Liver Cirrhosis
Logistic Models
Middle Aged
Multivariate Analysis
Non-alcoholic Fatty Liver Disease
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Transient elastography
Liver steatosis
Liver fibrosis
Issue dateAug-2019
PublisherTaylor and Francis
JournalScandinavian Journal of Gastroenterology
Abstract(s)Background: Obesity is one of the main factors of transient elastography (TE) failure, considering body mass index (BMI) ≥28 kg/m2 as a limiting factor. The XL probe was designed to overcome this limitation. Aim: To compare the feasibility of the M and XL probes in patients with BMI ≥ 28 kg/m2, to evaluate differences in mean values of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) between the two probes and find predictive factors of TE failure. Material and methods: Prospective study, including all patients with BMI ≥ 28 kg/m2 consecutively admitted for TE. Results: Included 161 patients. Measurements with M probe were reliable in 69.6% of the patients, with 68.2% of valid measurements in obese population and 58.9% in patients with skin-capsule distance (SCD) >25 mm. In 40 patients (81.6%) with an invalid M probe measurement, a reliable result was obtained with XL probe. We found that SCD >25 mm was the only predictor of M probe failure (OR: 4.9, CI: 1.64-14.63, p = .004). In those patients in which TE was possible with both probes (n = 112), mean CAP was 304 ± 49 dB/m2 with M probe and 301 ± 50 dB/m2 with XL probe (p = .59). Regarding liver stiffness, a mean value of 7.58 ± 3.47 kpas was obtained with the M probe and 6.21 ± 3.44 kpas with the XL probe (p < .001). Conclusion: There is a reliable applicability of the M probe in a high number (68.2%) of patients with a BMI ≥30 kg/m2. A SCD >25 mm was the only predictive factor of M probe failure. Mean values of LSM with XL probe were lower than those obtained with M probe.
AccessRestricted access (Author)
Appears in Collections:ICVS - Artigos em revistas internacionais / Papers in international journals

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