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Fibrosis and Prognosis Assessment Using Liver Stiffness in Patients with PBC and PSC

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Liver Elastography

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Abstract

Primary biliary cholangitis and primary sclerosing cholangitis (PSC) are the two most frequent chronic cholestatic liver diseases in adults. These cholangiopathies are characterized by progressive bile duct destruction, chronic cholestasis, and development of liver fibrosis and cirrhosis. In both the diseases, severe fibrosis and cirrhosis are major determinants of prognosis. The purpose of this chapter is to provide clinicians with a brief overview of what should be known about utility and limitation of elastography-based assessment of both fibrosis and prognosis in PBC and PSC. In brief summary, elastography-based techniques to measure liver stiffness show high performance for the assessment of F3 and F4 fibrosis and prediction of long-term outcomes for both PBC and PSC. In addition, elastography performs better than serum markers. For transient elastography and both diseases, cut-off values for F3 fibrosis and F4 cirrhosis can reasonably be considered as >10 kPa and >15 kPa, respectively, with AUROCs of higher than 0.85 and 0.95, respectively. These techniques should therefore be considered in clinical practice to assess the severity of the disease and its progression. They may be considered as well for risk stratification and definition of surrogate endpoints in clinical trials.

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Conflict of Interest: None.

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Authors and Affiliations

  1. Reference Center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, Saint-Antoine Hospital, Assistance Publique—Hôpitaux de Paris, Paris, France

    Christophe Corpechot

  2. Inserm UMR_S938, Saint-Antoine Research Center (CRSA), Sorbonne University, Paris, France

    Christophe Corpechot

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  1. Christophe Corpechot
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Correspondence to Christophe Corpechot .

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Editors and Affiliations

  1. Department of Medicine and Center for Alcohol Research and Liver Diseases, Salem Medical Center, University of Heidelberg, Heidelberg, Germany

    Sebastian Mueller

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Corpechot, C. (2020). Fibrosis and Prognosis Assessment Using Liver Stiffness in Patients with PBC and PSC. In: Mueller, S. (eds) Liver Elastography. Springer, Cham. https://doi.org/10.1007/978-3-030-40542-7_18

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  • DOI: https://doi.org/10.1007/978-3-030-40542-7_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-40541-0

  • Online ISBN: 978-3-030-40542-7

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