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Controlled Attenuation Parameter (CAP) with the XL Probe of the Fibroscan®: A Comparative Study with the M Probe and Liver Biopsy

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Abstract

Introduction

Controlled attenuation parameter (CAP) is a new method for the diagnosis of steatosis. Until now, CAP was available only with the M probe of the Fibroscan. The aim of this study was to evaluate the diagnostic performance of CAP with the XL probe versus CAP with the M probe, using liver biopsy (LB) as gold standard.

Patients and Methods

A total of 236 patients with chronic liver disease undergoing LB had CAP measurement with M and XL probes the same day. All LB were analyzed independently by two experienced pathologists.

Results

Median CAP was 240.5 and 239.5 dB/m with the M and XL probes, respectively. For the detection of steatosis grade with the M and XL probes, AUROCs were 0.82/0.83 for S ≥ 1, 0.89/0.88 for S ≥ 2, and 0.92/0.93 for S3, respectively. Cutoffs were (M and XL probes) 246/242 for S ≥ 1, 269/267 for S ≥ 2, and 285/286 dB/m for S3, respectively. The factor significantly associated with CAP with the M and XL probes was steatosis grade. In multivariate analysis, a low CAP value with XL probe was negatively associated with waist circumference, triglycerides, albumin, and the alcohol consumption, and positively with alkaline phosphatases. In multivariate analysis, a high CAP value with the XL probe was positively associated with waist circumference and triglycerides.

Conclusion

CAP with the XL probe is a new tool for the diagnosis of steatosis. This parameter could be useful for the diagnosis and the follow-up of obese patients.

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Abbreviations

CAP:

Controlled attenuation parameter

LB:

Liver biopsy

AUROC:

Area under the receiver operating curve (ROC)

NAFLD:

Nonalcoholic fatty liver disease

BMI:

Body mass index

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

IQR:

Interquartile range

LSM:

Liver stiffness measurement

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Author’s contributions

VL performed research, analyzed data, designed research study, and wrote paper. JV performed research and analyzed data. JH, WM, and PB performed research. VP performed research and designed research study. All authors approved the final version of the manuscript.

Funding

Funding for this study was obtained from Echosens (Paris).

Author information

Authors and Affiliations

  1. Centre d’Investigation de la Fibrose hépatique, Service d’Hépato-Gastroentérologie, Hôpital Haut-Lévêque, Centre Hospitalo-Universitaire de Bordeaux, 33604, Pessac, France

    Victor de Lédinghen, Jean-Baptiste Hiriart, Julien Vergniol & Wassil Merrouche

  2. INSERM U1053, Université Bordeaux, Bordeaux, France

    Victor de Lédinghen

  3. Department of Pathology, Physiology and Imaging, Hôpital Beaujon, Clichy, France

    Pierre Bedossa & Valérie Paradis

Authors
  1. Victor de Lédinghen
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  2. Jean-Baptiste Hiriart
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  3. Julien Vergniol
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  4. Wassil Merrouche
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  5. Pierre Bedossa
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  6. Valérie Paradis
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Corresponding author

Correspondence to Victor de Lédinghen.

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Conflict of interest

Victor de Lédinghen: SuperSonic Imagine. Other authors: no conflict of interest.

Electronic supplementary material

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10620_2017_4638_MOESM1_ESM.tiff

Supplementary file Fig. 1. Controlled attenuation parameter (CAP) measured with the M probe versus the CAP measured with the XL probe

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de Lédinghen, V., Hiriart, JB., Vergniol, J. et al. Controlled Attenuation Parameter (CAP) with the XL Probe of the Fibroscan®: A Comparative Study with the M Probe and Liver Biopsy. Dig Dis Sci 62, 2569–2577 (2017). https://doi.org/10.1007/s10620-017-4638-3

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  • DOI: https://doi.org/10.1007/s10620-017-4638-3

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