P-60 DIAGNOSTIC PERFORMANCE OF FIBROSCAN FOR LIVER DISEASE IN BOGOTA, COLOMBIA

Introduction and Objectives

In the diagnostic process of liver diseases the clinical history and hepatic biochemical profile are fundamental. Liver biopsy is the gold standard for diagnosis, evaluation of activity, fibrosis status or therapeutic response. It is an invasive procedure with risk of complications. With respect to fibrosis staging, a key point in decision making in follow-up and treatment, non-invasive tests have been developed that are easily accessible and without resorting to biopsy. The calculation of the FIB-4 and APRI indices is useful in general practice, but not sufficient to determine the degree of fibrosis in early and intermediate stages. Liver fibrosis increases stiffness and decreases tissue elasticity and can be assessed by Elastography, this technique is sensitive to differentiate patients without fibrosis from those with advanced fibrosis, in a fast and well tolerated way. This study aims to describe the diagnostic performance for detecting liver fibrosis of FibroScan compared with APRI and FIB4 indices versus liver biopsy in patients with liver disease in Bogota.

Materials and Methods

Retrospective cohort study, cross-sectional, consecutive sampling, performed in the period 2019-2022, the APRI, FIB4 and Fibroscan indices were compared with the biopsy result, the diagnostic accuracy measures for APRI, FIB4 and FibroScan were described and an area under the curve analysis (ACOR) was performed.

Results

Biopsy was positive for fibrosis in 40%, FibroScan showed excellent performance for detecting fibrosis, with an ACOR of 0.90 (CI: 0.83 - 0.97), APRI indices of 0.52 (CI: 0.35- 0.68) and FIB4 of 0.52 (CI:0.37 - 0.68).

Conclusions

FibroScan is a useful tool for the diagnosis and follow-up of chronic liver disease, it should be used in combination with other diagnostic tests and clinical evaluation. FibroScan showed excellent performance in discriminating patients with liver fibrosis compared to APRI and FIB4 indices and is better at detecting advanced stages.