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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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.
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.
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.
KeywordsControlled attenuation parameter (CAP) Liver stiffness Transient elastography Fibroscan Obesity NAFLD Metabolic syndrome Steatosis
Controlled attenuation parameter
Area under the receiver operating curve (ROC)
Nonalcoholic fatty liver disease
Body mass index
Hepatitis B virus
Hepatitis C virus
Liver stiffness measurement
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 for this study was obtained from Echosens (Paris).
Compliance with ethical standards
Conflict of interest
Victor de Lédinghen: SuperSonic Imagine. Other authors: no conflict of interest.
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