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Journal articles on the topic 'Fibrosis Assessment'

Author: Grafiati

Published: 25 May 2024

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1

Virarkar, Mayur, Ajaykumar C. Morani, Melissa W. Taggart, and Priya Bhosale. "Liver Fibrosis Assessment." Seminars in Ultrasound, CT and MRI 42, no. 4 (August 2021): 381–89. http://dx.doi.org/10.1053/j.sult.2021.03.003.

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2

Loomba, Rohit, and Leon A. Adams. "Advances in non-invasive assessment of hepatic fibrosis." Gut 69, no. 7 (February 17, 2020): 1343–52. http://dx.doi.org/10.1136/gutjnl-2018-317593.

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Liver fibrosis should be assessed in all individuals with chronic liver disease as it predicts the risk of future liver-related morbidity and thus need for treatment, monitoring and surveillance. Non-invasive fibrosis tests (NITs) overcome many limitations of liver biopsy and are now routinely incorporated into specialist clinical practice. Simple serum-based tests (eg, Fibrosis Score 4, non-alcoholic fatty liver disease Fibrosis Score) consist of readily available biochemical surrogates and clinical risk factors for liver fibrosis (eg, age and sex). These have been extensively validated across a spectrum of chronic liver diseases, however, tend to be less accurate than more ‘complex’ serum tests, which incorporate direct measures of fibrogenesis or fibrolysis (eg, hyaluronic acid, N-terminal propeptide of type three collagen). Elastography methods quantify liver stiffness as a marker of fibrosis and are more accurate than simple serum NITs, however, suffer increasing rates of unreliability with increasing obesity. MR elastography appears more accurate than sonographic elastography and is not significantly impacted by obesity but is costly with limited availability. NITs are valuable for excluding advanced fibrosis or cirrhosis, however, are not sufficiently predictive when used in isolation. Combining serum and elastography techniques increases diagnostic accuracy and can be used as screening and confirmatory tests, respectively. Unfortunately, NITs have not yet been demonstrated to accurately reflect fibrosis change in response to treatment, limiting their role in disease monitoring. However, recent studies have demonstrated lipidomic, proteomic and gut microbiome profiles as well as microRNA signatures to be promising techniques for fibrosis assessment in the future.

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Masuzaki, Ryota, Tatsuo Kanda, Reina Sasaki, Naoki Matsumoto, Masahiro Ogawa, Shunichi Matsuoka, Seth J. Karp, and Mitsuhiko Moriyama. "Noninvasive Assessment of Liver Fibrosis: Current and Future Clinical and Molecular Perspectives." International Journal of Molecular Sciences 21, no. 14 (July 11, 2020): 4906. http://dx.doi.org/10.3390/ijms21144906.

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Liver fibrosis is one of the risk factors for hepatocellular carcinoma (HCC) development. The staging of liver fibrosis can be evaluated only via a liver biopsy, which is an invasive procedure. Noninvasive methods for the diagnosis of liver fibrosis can be divided into morphological tests such as elastography and serum biochemical tests. Transient elastography is reported to have excellent performance in the diagnosis of liver fibrosis and has been accepted as a useful tool for the prediction of HCC development and other clinical outcomes. Two-dimensional shear wave elastography is a new technique and provides a real-time stiffness image. Serum fibrosis markers have been studied based on the mechanism of fibrogenesis and fibrolysis. In the healthy liver, homeostasis of the extracellular matrix is maintained directly by enzymes called matrix metalloproteinases (MMPs) and their specific inhibitors, tissue inhibitors of metalloproteinases (TIMPs). MMPs and TIMPs could be useful serum biomarkers for liver fibrosis and promising candidates for the treatment of liver fibrosis. Further studies are required to establish liver fibrosis-specific markers based on further clinical and molecular research. In this review, we summarize noninvasive fibrosis tests and molecular mechanism of liver fibrosis in current daily clinical practice.

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Castera, Laurent. "Noninvasive Assessment of Liver Fibrosis." Digestive Diseases 33, no. 4 (2015): 498–503. http://dx.doi.org/10.1159/000374097.

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Background: The prognosis and management of chronic liver diseases greatly depend on the amount and progression of liver fibrosis with the risk of developing cirrhosis. Liver biopsy, traditionally considered as the reference standard for the staging of fibrosis, has been challenged over the past decade by the development of novel noninvasive methodologies. Key Messages: Noninvasive methods rely on two different but complementary approaches: a ‘biological' approach based on the dosage serum biomarkers, and a ‘physical' approach based on the measurement of liver stiffness using transient elastography (TE). There are two clinically relevant endpoints for the staging of liver fibrosis: (1) significant fibrosis (indication for antiviral treatment in viral hepatitis B and C), and (2) cirrhosis (indication for screening of esophageal varices and hepatocellular carcinoma). TE (FibroScan®), FibroTest® and APRI have been the most extensively studied and validated methods, mainly in chronic hepatitis C. Combining two unrelated methods, such as TE and biomarkers, is an attractive approach that increases diagnostic performance and limits the drawback of both methodologies. TE appears to be an excellent tool for the early detection of cirrhosis with likely prognostic value in this setting. Thus far, however, it cannot replace upper endoscopy for screening of esophageal varices. The main limitation of TE in clinical practice is the impossibility of obtaining reliable liver stiffness measurements in around 20% of cases, mainly comprising obese patients. Conclusion: An increasing number of reliable noninvasive methods are now available that are widely used in clinical practice, mostly in viral hepatitis, resulting in a significant decrease in the need for liver biopsy.

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Mesa, Ruben A. "Detangling fibrosis assessment in MPNs." Leukemia Research 34, no. 7 (July 2010): 854–55. http://dx.doi.org/10.1016/j.leukres.2010.01.014.

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6

Hall, P. de la M., M. A. Jenner, L. R. Jarvis, and M. Ahern. "Morphometric assessment of hepatic fibrosis." Pathology 23 (1991): 2. http://dx.doi.org/10.1016/s0031-3025(16)36166-9.

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7

Jellis, Christine, Jennifer Martin, Jagat Narula, and Thomas H. Marwick. "Assessment of Nonischemic Myocardial Fibrosis." Journal of the American College of Cardiology 56, no. 2 (July 2010): 89–97. http://dx.doi.org/10.1016/j.jacc.2010.02.047.

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8

Kelleher, T. Barry, and Nezam Afdhal. "Noninvasive Assessment of Liver Fibrosis." Clinics in Liver Disease 9, no. 4 (November 2005): 667–83. http://dx.doi.org/10.1016/j.cld.2005.08.002.

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9

Bonder, Alan, Elliot B. Tapper, and Nezam H. Afdhal. "Contemporary Assessment of Hepatic Fibrosis." Clinics in Liver Disease 19, no. 1 (February 2015): 123–34. http://dx.doi.org/10.1016/j.cld.2014.09.007.

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10

Barr, Richard G., Giovanna Ferraioli, Mark L. Palmeri, Zachary D. Goodman, Guadalupe Garcia-Tsao, Jonathan Rubin, Brian Garra, et al. "Elastography Assessment of Liver Fibrosis." Ultrasound Quarterly 32, no. 2 (June 2016): 94–107. http://dx.doi.org/10.1097/ruq.0000000000000209.

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11

Martínez, Stella M., Gonzalo Crespo, Miquel Navasa, and Xavier Forns. "Noninvasive assessment of liver fibrosis." Hepatology 53, no. 1 (November 29, 2010): 325–35. http://dx.doi.org/10.1002/hep.24013.

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12

Nguyen, Doris, and Jayant A. Talwalkar. "Noninvasive assessment of liver fibrosis." Hepatology 53, no. 6 (May 25, 2011): 2107–10. http://dx.doi.org/10.1002/hep.24401.

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13

Shurygina, E. I., N. V. Makarenko, N. S. Karnaukhov, Yu B. Nikonova, E. A. Dubtsova, L. V. Vinokurova, K. A. Lesko, S. G. Khomeriki, D. S. Bordin, and I. E. Khatkov. "Methods of pancreatic fibrosis assessment." Russian Journal of Evidence-Based Gastroenterology 13, no. 1 (2024): 48. http://dx.doi.org/10.17116/dokgastro20241301148.

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14

Mik, Patrik, Katsiaryna Barannikava, and Polina Surkova. "Biased Quantification of Rat Liver Fibrosis—Meta-Analysis with Practical Recommendations and Clinical Implications." Journal of Clinical Medicine 12, no. 15 (August 1, 2023): 5072. http://dx.doi.org/10.3390/jcm12155072.

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For liver fibrosis assessment, the liver biopsy is usually stained with Masson’s trichrome (MT) or picrosirius red (PSR) to quantify liver connective tissue (LCT) for fibrosis scoring. However, several concerns of such semiquantitative assessments have been raised, and when searching for data on the amount of LCT in healthy rats, the results vastly differ. Regarding the ongoing reproducibility crisis in science, it is necessary to inspect the results and methods, and to design an unbiased and reproducible method of LCT assessment. We searched the Medline database using search terms related to liver fibrosis, LCT and collagen, rat strains, and staining methods. Our search identified 74 eligible rat groups in 57 studies. We found up to 170-fold differences in the amount of LCT among healthy Wistar and Sprague–Dawley rats, with significant differences even within individual studies. Biased sampling and quantification probably caused the observed differences. In addition, we also found incorrect handling of liver fibrosis scoring. Assessment of LCT using stereological sampling methods (such as systematic uniform sampling) would provide us with unbiased data. Such data could eventually be used not only for the objective assessment of liver fibrosis but also for validation of noninvasive methods of the assessment of early stages of liver fibrosis.

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D’Agnano, Vito, Domenica Francesca Mariniello, Michela Ruotolo, Gianluca Quarcio, Alessandro Moriello, Stefano Conte, Antonio Sorrentino, Stefano Sanduzzi Zamparelli, Andrea Bianco, and Fabio Perrotta. "Targeting Progression in Pulmonary Fibrosis: An Overview of Underlying Mechanisms, Molecular Biomarkers, and Therapeutic Intervention." Life 14, no. 2 (February 6, 2024): 229. http://dx.doi.org/10.3390/life14020229.

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Interstitial lung diseases comprise a heterogenous range of diffuse lung disorders, potentially resulting in pulmonary fibrosis. While idiopathic pulmonary fibrosis has been recognized as the paradigm of a progressive fibrosing interstitial lung disease, other conditions with a progressive fibrosing phenotype characterized by a significant deterioration of the lung function may lead to a burden of significant symptoms, a reduced quality of life, and increased mortality, despite treatment. There is now evidence indicating that some common underlying biological mechanisms can be shared among different chronic fibrosing disorders; therefore, different biomarkers for disease-activity monitoring and prognostic assessment are under evaluation. Thus, understanding the common pathways that induce the progression of pulmonary fibrosis, comprehending the diversity of these diseases, and identifying new molecular markers and potential therapeutic targets remain highly crucial assignments. The purpose of this review is to examine the main pathological mechanisms regulating the progression of fibrosis in interstitial lung diseases and to provide an overview of potential biomarker and therapeutic options for patients with progressive pulmonary fibrosis.

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16

Ahmed, Rida Rubab, Ambeen Usmani, Muhammad Shahid, Mazhar Ul Haque, Imran Khan Khattak, and Ashfaq Hussain. "Morphological Assessment Of Epithelium and Nucleus in Oral Submucous Fibrosis Individuals." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 26, 2022): 189–91. http://dx.doi.org/10.53350/pjmhs22165189.

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Aim: To evaluate histomorphological alterations present within nucleus and epithelium in oral submucous fibrosis subjects Methods: This study recruited 50 clinically diagnosed cases of oral submucous fibrosis which were active chewers of areca nut and associated products. Oral mucosa tissue blocks were prepared and processed followed by staining with Hematoxylin & Eosin to observe morphological features. The findings were statistically analyzed through SPSS version 23 Results: Amongst the sample size of 50, 33(66%) of cases had pleomorphic nuclear structure out of which 21(91.3%) had prominent nucleoli. High statistical significance was appreciated relating to involvement of nuclear and nucleoli structure. In addition, epithelial demarcation was appreciated within epithelium present in disease. 37(74%) cases were histologically identified cases of fibrosed structure out of which 31(83.8%) of the subjects had hyperplasia in epithelial lining. Hyperplastic epithelium was significantly correlated with OSMF. However, strength of association was weak with a p value of 0.04 Conclusion: The results revealed pleomorphism in nuclei underlining a strong association of structural alteration with disease initiation and progression. Hyperplastic stratified squamous epithelium was found in abundance which could be attributed to adaptive response of epithelium to inflammatory alkaloids present in areca nut products. Such findings could serve as trigger factor for oral submucous fibrosis and should be considered significant for early diagnosis and treatment management. Keywords: Oral submucous fibrosis,epithelium, nuclei, nucleoli, histology.

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17

Poynard, Thierry, Rachel Morra, Patrick Ingiliz, Francoise Imbert-Bismut, Dominique Thabut, Djamila Messous, Mona Munteanu, Julien Massard, Yves Benhamou, and Vlad Ratziu. "Assessment of liver fibrosis: Noninvasive means." Saudi Journal of Gastroenterology 14, no. 4 (2008): 163. http://dx.doi.org/10.4103/1319-3767.43273.

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18

Walkowiak, Jaroslaw. "Assessment of maldigestion in cystic fibrosis." Journal of Pediatrics 145, no. 3 (September 2004): 285–87. http://dx.doi.org/10.1016/j.jpeds.2004.06.033.

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19

Labombarda, Fabien, Arnaud Pellissier, Madiha Ellafi, C. Creveuil, Virginie Ribault, Murielle Laurans, Marcel Guillot, et al. "Myocardial Strain Assessment in Cystic Fibrosis." Journal of the American Society of Echocardiography 24, no. 9 (September 2011): 1037–45. http://dx.doi.org/10.1016/j.echo.2011.06.004.

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20

Redman, Joseph, and Richard K. Sterling. "Non-invasive Assessment of Liver Fibrosis." Current Treatment Options in Gastroenterology 18, no. 2 (March 31, 2020): 255–69. http://dx.doi.org/10.1007/s11938-020-00285-z.

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21

Jin, Young-Joo. "Diagnostic Assessment of Nonalcoholic Fatty Liver Disease." Korean Journal of Medicine 95, no. 5 (October 1, 2020): 299–307. http://dx.doi.org/10.3904/kjm.2020.95.5.299.

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Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide, and is characterized by fat accumulation at levels exceeding 5% in hepatocytes due to insulin resistance. The disease spectrum ranges from simple nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH)/NASH-related fibrosis or cirrhosis defined by histological findings. Unlike simple NAFL, NASH/NASH-related fibrosis or cirrhosis increases the risk of liver-related morbidity or mortality. Therefore, accurate diagnosis of NASH/NASH-related fibrosis or cirrhosis is needed for management of patients with these diseases. Currently, liver biopsy is the only way to confirm the presence of NASH in an individual with features of NAFLD, but this has some limitations, including sample error, interpretation error, and the invasiveness of the procedure. Therefore, there have been a number of attempts to develop noninvasive methods for differential diagnosis of NASH/NASH-related fibrosis or cirrhosis easily and quickly. Here, we review the assessments for diagnosing NAFLD and the methods for differential diagnosis of NASH/NASH-related fibrosis or cirrhosis.

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22

Mardini, H., and C. Record. "Detection assessment and monitoring of hepatic fibrosis: biochemistry or biopsy?" Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 42, no. 6 (November 1, 2005): 441–47. http://dx.doi.org/10.1258/000456305774538210.

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Hepatic fibrosis is an important consequence of inflammatory disorders affecting the liver, and ultimately progresses to cirrhosis. Here we explore methods for the detection and monitoring of hepatic fibrosis, particularly in hepatitis C, alcoholic liver disease, non-alcoholic fatty liver disease and during methotrexate therapy, in all of which progressive fibrosis can develop over a number of years in a minority of patients. Liver biopsy currently remains the gold standard to assess fibrosis. However, it has several limitations, including manpower issues, cost, risk of patient injury, including mortality and morbidity, observer variability and sampling variation. Several non-invasive diagnostic tests for fibrosis and cirrhosis have therefore been evaluated. The usefulness of a laboratory test for screening for a pathological abnormality such as fibrosis is critically dependent on the prevalence of the pathology in the population under investigation. When the prevalence is expected to be low, screening tests should have a high negative predictive value so that large numbers of patients can be spared the next diagnostic step, namely liver biopsy. For the moment, clinical chemistry laboratories should offer the aspartate aminotransferase alanine aminotransferase ratio, AST/platelet ratio and the Rosenberg fibrosis index as part of their routine service for monitoring the development of hepatic fibrosis.

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23

Almaas, Vibeke M., Kristina H. Haugaa, Erik H. Strøm, Helge Scott, Hans-Jørgen Smith, Christen P. Dahl, Odd R. Geiran, et al. "Noninvasive assessment of myocardial fibrosis in patients with obstructive hypertrophic cardiomyopathy." Heart 100, no. 8 (December 24, 2013): 631–38. http://dx.doi.org/10.1136/heartjnl-2013-304923.

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ObjectiveLate gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging is the reference standard for non-invasive assessment of fibrosis. In hypertrophic cardiomyopathy (HCM) patients the histological substrate for LGE is still unknown. The aim of this study was to assess the ability of LGE and strain echocardiography to detect type and extent of myocardial fibrosis in obstructive HCM patients undergoing septal myectomy.MethodsThirty-two HCM patients (age 60±10) were included in this cross-sectional study and preoperatively examined by speckle-tracking strain echocardiography and LGE-CMR (n=21). Histological fibrosis was classified as interstitial, replacement and total.ResultsHistological fibrosis was present in 31 patients. The percentage of total, interstitial and replacement fibrosis was 15(7, 31)%, 11(5, 24)% and 3(1, 6)%, respectively. Reduced longitudinal septal strain correlated with total (r=0.50, p=0.01) and interstitial (r=0.40, p=0.03), but not with replacement fibrosis (r=0.28, p=0.14). Septal LGE was detected in 13/21 (62%), but percentage LGE did not correlate with total fibrosis (r=0.25, p=0.28). Extent of fibrosis did not differ between patients with and without septal LGE (20(9, 58)% versus 14(5, 19)% p=0.41). Patients with ventricular arrhythmias (n=8) had lower septal longitudinal strain and increased extent total and interstitial fibrosis in myectomy specimens, but no differences were demonstrated in LGE. Reduced longitudinal septal strain and increased extent of interstitial fibrosis predicted ventricular arrhythmias independently of age and gender.ConclusionsIn myectomised HCM patients, reduced longitudinal septal strain correlated better with interstitial and total fibrosis in myectomy specimens, and was a more powerful tool to predict arrhythmias than LGE.

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Chantaduly, Chanon, Hayden R. Troutt, Karla A. Perez Reyes, Jonathan E. Zuckerman, Peter D. Chang, and Wei Ling Lau. "Artificial Intelligence Assessment of Renal Scarring (AIRS Study)." Kidney360 3, no. 1 (November 11, 2021): 83–90. http://dx.doi.org/10.34067/kid.0003662021.

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BackgroundThe goal of the Artificial Intelligence in Renal Scarring (AIRS) study is to develop machine learning tools for noninvasive quantification of kidney fibrosis from imaging scans.MethodsWe conducted a retrospective analysis of patients who had one or more abdominal computed tomography (CT) scans within 6 months of a kidney biopsy. The final cohort encompassed 152 CT scans from 92 patients, which included images of 300 native kidneys and 76 transplant kidneys. Two different convolutional neural networks (slice-level and voxel-level classifiers) were tested to differentiate severe versus mild/moderate kidney fibrosis (≥50% versus <50%). Interstitial fibrosis and tubular atrophy scores from kidney biopsy reports were used as ground-truth.ResultsThe two machine learning models demonstrated similar positive predictive value (0.886 versus 0.935) and accuracy (0.831 versus 0.879).ConclusionsIn summary, machine learning algorithms are a promising noninvasive diagnostic tool to quantify kidney fibrosis from CT scans. The clinical utility of these prediction tools, in terms of avoiding renal biopsy and associated bleeding risks in patients with severe fibrosis, remains to be validated in prospective clinical trials.

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25

Khodjaeva, M. E., A. S. Khikmatullaeva, N. S. Ibadullaeva, M. A. Abdukadirova, K. E. Novak, and E. V. Esaulenko. "MicroRNA-122: assessment of diagnostic significance in HDV infection." Journal Infectology 16, no. 1 (April 7, 2024): 56–61. http://dx.doi.org/10.22625/2072-6732-2024-16-1-56-61.

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Aim: To evaluate the diagnostic significance of the relationship between the level of microRNA-122 expression and liver fibrosis during HDV infection.Materials and methods. The expression of microRNA-122 was determined in 203 blood samples. Blood sampling was done from 53 patients with chronic viral hepatitis D, 49 patients with liver cirrhosis of HDV etiology, and 69 patients with newly diagnosed HBs antigenemia. The control group consisted of practically healthy individuals (n=32).Results. In patients with negative RNA HDV levels, the level of microRNA-122 in the blood serum was significantly higher than in samples with positive RNA HDV levels (14.0±2.8 2^-ΔΔCt and 1.6±0.17 2^-ΔΔCt) (p ˂ 0.005). Meanwhile, in healthy individuals, the expression of microRNA-122 was statistically significantly lower – 1.3±0.03 2^-ΔΔCt (p ˂ 0.005). Undetectable levels of HDV RNA in the serum were accompanied by a high HBV viral load and a significantly higher level of microRNA-122, which was 8.7 times higher than in the group of HDV RNA-positive patients (p<0.005). In patients with liver fibrosis F1, the expression of microRNA-122 was higher than in patients with liver fibrosis F2, F3, F4 (p = 0.0001). The lowest levels of microRNA-122 were observed in liver fibrosis F4. Conclusion. The expression level of microRNA-122 in blood serum during HDV infection decreases as liver fibrosis progresses. The development of cirrhosis is accompanied by a 3.7-fold drop in the level of microRNA-122 compared to the group of patients with chronic hepatitis D. MicroRNA-122 can be used in laboratory monitoring of patients with various stages of HDV infection as an indicator of the activity of the process, assessing the severity of liver damage and the rate of progression of liver fibrosis.> ˂ 0.005). In patients with liver fibrosis F1, the expression of microRNA-122 was higher than in patients with liver fibrosis F2, F3, F4 (p = 0.0001). The lowest levels of microRNA-122 were observed in liver fibrosis F4.Conclusion. The expression level of microRNA-122 in blood serum during HDV infection decreases as liver fibrosis progresses. The development of cirrhosis is accompanied by a 3.7-fold drop in the level of microRNA-122 compared to the group of patients with chronic hepatitis D. MicroRNA-122 can be used in laboratory monitoring of patients with various stages of HDV infection as an indicator of the activity of the process, assessing the severity of liver damage and the rate of progression of liver fibrosis.

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26

An, Zhe, Guang Yang, Haikuo Zheng, Wei Nie, and Guohui Liu. "Biomarkers in patients with myocardial fibrosis." Open Life Sciences 12, no. 1 (October 23, 2017): 337–44. http://dx.doi.org/10.1515/biol-2017-0039.

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AbstractMyocardial fibrosis is observed in many cardiovascular diseases including hypertension, heart failure and cardiomyopathy. Myocardial fibrosis has been proved to be reversible and treatable only under timely intervention, which makes early detection and assessment of fibrosis crucial. Aside from tissue biopsy as the gold standard for the diagnosis of myocardial fibrosis, circulating biomarkers have been adopted as noninvasive assessment of this lesion. Dysregulated collagen deposition is thought to be the major cause of myocardial fibrosis. Collagens, procollagens, TGF-β, TIMP, galectin-3, and microRNAs are thought to be indicators of myocardial fibrosis. In this review, we summarize the molecules that are frequently used as biomarkers in diagnosis of cardiac fibrosis. Mechanisms of fibrosis that they take part in are also introduced.

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27

Karanjia, Rustam N., Mary M. E. Crossey, I. Jane Cox, Haddy K. S. Fye, Ramou Njie, Robert D. Goldin, and Simon D. Taylor-Robinson. "Hepatic steatosis and fibrosis: Non-invasive assessment." World Journal of Gastroenterology 22, no. 45 (2016): 9880. http://dx.doi.org/10.3748/wjg.v22.i45.9880.

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28

Zaleska-Dorobisz, Urszula, Aleksander Pawluś, Marta Kucharska, and Marcin Inglot. "SWE elastography in assessment of liver fibrosis." Postępy Higieny i Medycyny Doświadczalnej 69 (February 15, 2015): 221–26. http://dx.doi.org/10.5604/17322693.1140338.

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Ferraioli, Giovanna, and Richard G. Barr. "Ultrasound liver elastography beyond liver fibrosis assessment." World Journal of Gastroenterology 26, no. 24 (June 28, 2020): 3413–20. http://dx.doi.org/10.3748/wjg.v26.i24.3413.

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Aurora, P., P. Whitmore, and B. F. Whitehead. "Assessment for lung transplantation in cystic fibrosis." Journal of the Royal Society of Medicine 92, no. 37_suppl (December 1999): 31–34. http://dx.doi.org/10.1177/014107689909237s06.

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31

ZHOU, Kun, and Lun Gen LU. "Assessment of fibrosis in chronic liver diseases." Journal of Digestive Diseases 10, no. 1 (February 2009): 7–14. http://dx.doi.org/10.1111/j.1751-2980.2008.00356.x.

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32

Ferrozzi, F., D. Bova, F. Campodonico, F. De Chiara, M. Uccelli, E. Bacchini, R. Grinzcich, G. L. dè Angelis, and A. Battistini. "Cystic fibrosis: MR assessment of pancreatic damage." Radiology 198, no. 3 (March 1996): 875–79. http://dx.doi.org/10.1148/radiology.198.3.8628886.

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Schönenberger, Katja A., Emilie Reber, Lia Bally, Thomas Geiser, Dagmar Lin, and Zeno Stanga. "Nutritional assessment in adults with cystic fibrosis." Nutrition 67-68 (November 2019): 110518. http://dx.doi.org/10.1016/j.nut.2019.05.010.

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Rolin, S. A., C. D. Sheldon, and N. J. Withers. "Assessment of bone mineralisation in cystic fibrosis." Journal of Cystic Fibrosis 8 (June 2009): S83. http://dx.doi.org/10.1016/s1569-1993(09)60327-1.

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35

Kerem, E., M. Wilschanski, G. L. Elfring, S. Hirawat, T. Pugatsch, A. Reha, S. Constantine, S. W. Peltz, and L. L. Miller. "Quantitative cough assessment in cystic fibrosis (CF)." Journal of Cystic Fibrosis 7 (June 2008): S59. http://dx.doi.org/10.1016/s1569-1993(08)60225-8.

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Davison, Suzanne. "Assessment of liver disease in cystic fibrosis." Paediatric Respiratory Reviews 27 (June 2018): 24–27. http://dx.doi.org/10.1016/j.prrv.2018.05.010.

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Ferrari, Victor A., Walter R. T. Witschey, and Rong Zhou. "Cardiac Magnetic Resonance Assessment of Myocardial Fibrosis." Circulation: Cardiovascular Imaging 4, no. 6 (November 2011): 604–6. http://dx.doi.org/10.1161/circimaging.111.969204.

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38

Nichols, E. H., and N. H. Afdhal. "Assessment of Liver Fibrosis With New Modalities." MD Conference Express 15, no. 14 (August 1, 2015): 5–7. http://dx.doi.org/10.1177/1559897715593901.

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Serajeddini, Hana, Marco Mura, and Paola Rogliani. "Multi-Dimensional Assessment in Idiopathic Pulmonary Fibrosis." Chest 152, no. 4 (October 2017): A446. http://dx.doi.org/10.1016/j.chest.2017.08.473.

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Thompson, Geoffrey N. "Assessment of taurine deficiency in cystic fibrosis." Clinica Chimica Acta 171, no. 2-3 (February 1988): 233–37. http://dx.doi.org/10.1016/0009-8981(88)90148-9.

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Bera, Chinmay, Nashla Hamdan-Perez, and Keyur Patel. "Non-Invasive Assessment of Liver Fibrosis in Hepatitis B Patients." Journal of Clinical Medicine 13, no. 4 (February 12, 2024): 1046. http://dx.doi.org/10.3390/jcm13041046.

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The aim of this review is to provide updated information on the clinical use of non-invasive serum and imaging-based tests for fibrosis assessment in chronic hepatitis B (CHB) virus infection. In recent years, non-invasive tests (NIT) have been increasingly used to determine eligibility for treatment. Liver biopsy is still considered the gold standard for assessing inflammatory activity and fibrosis staging, but it is an invasive procedure with inherent limitations. Simple serum markers such as APRI and FIB-4 are limited by indeterminate results but remain useful initial tests for fibrosis severity if imaging elastography is not available. Point-of-care US-based elastography techniques, such as vibration-controlled transient elastography or 2D shear wave elastography, are increasingly available and have better accuracy than simple serum tests for advanced fibrosis or cirrhosis, although stiffness cut-offs are variable based on E-antigen status and inflammatory activity. Current NITs have poor diagnostic performance for following changes in fibrosis with antiviral therapy. However, NITs may have greater clinical utility for determining prognosis in patients with CHB that have advanced disease, especially for the development of hepatocellular carcinoma and/or liver decompensation. Algorithms combining serum and imaging NITs appear promising for advanced fibrosis and prognostic risk stratification.

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Sah, Manoj Kumar, Bhupenndra Kumar Basnet, Nandu Silwal Poudyal, Niyanta Karki, and Roshan Shrestha. "Noninvasive assessment of liver fibrosis in Nonalcoholic Fatty Liver Disease in Nepal." Journal of Advances in Internal Medicine 9, no. 1 (May 28, 2020): 25–28. http://dx.doi.org/10.3126/jaim.v9i1.29163.

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Background and Aims: Nonalcoholic Fatty Liver Disease (NAFLD) progresses to liver fibrosis and ultimately cirrhosis and its complications. Grading of liver fibrosis 2D SWE (Shear Wave Elastography) is a noninvasive study of liver fibrosis and stiffness. We compared different fibrosis scores (NAFLD fibrosis score, FIB 4 score, APRI score) and ultra-sonogram identified fatty liver with 2d shear wave elastography score. Methods: A hospital based prospective observational study was conducted from May 2019 for ten months period in the Gastroenterology and Liver Unit, NAMS, Nepal. Seventy patients with known fatty liver and its severity were identified by Ultrasonogram criteria were enrolled, who met the exclusion criteria. All patients underwent 2D shear wave elastography. Patients were evaluated for effects of obesity, diabetes mellitus, thyroid related disease and dyslipidemias on NAFLD. Tests were done to calculate diﬀerent fibrosis scores (NAFLD Fibrosis, FIB4, APRI, AST/ALT ratio) and compared with 2d shear wave score. Results: Baseline Characteristics among 70 patients 39(55.7%) were male and 31(44.3%) were female with mean age of the patients 44.3 years. Most of the patients were overweight with mean BMI of 28.2, kg/m2among them 51(72.9%) patients were more than 25.kg/m2Most of the patients 41.4% had diabetes mellitus, 77.1% had hypertension, 30% had hypothyroidism and were 25.9% had metabolic syndrome. Majority of patients on ultrasound gradings were mild 64.28%, 25.72% were moderate and only 10 % were in severe groups. In comparison ultra-sonogram with 2 d shear wave elastography, mild grade mean fibrosis 7.07 kpa, for moderate grade mean fibrosis 8.22 kpa and for severe grade mean fibrosis was 18.16 kpa. Conclusion: In patients with NAFLD, measurement of liver stiffness by 2d shear wave elastography has positively correlated with FIB-4 score and non-inferior to NAFLD fibrosis score. The mean value of elastography increases significantly with the severity of steatosis on ultrasonography.

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Minamikawa, Takeo, Eiji Hase, Mayuko Ichimura-Shimizu, Yuki Morimoto, Akihiro Suzuki, Takeshi Yasui, Satoko Nakamura, Akemi Tsutsui, Koichi Takaguchi, and Koichi Tsuneyama. "Assessment of Ultra-Early-Stage Liver Fibrosis in Human Non-Alcoholic Fatty Liver Disease by Second-Harmonic Generation Microscopy." International Journal of Molecular Sciences 23, no. 6 (March 20, 2022): 3357. http://dx.doi.org/10.3390/ijms23063357.

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Non-alcoholic fatty liver disease (NAFLD) is associated with the chronic progression of fibrosis. In general, the progression of liver fibrosis is determined by a histopathological assessment with a collagen-stained section; however, the ultra-early stage of liver fibrosis is challenging to identify because of the low sensitivity in the collagen-selective staining method. In the present study, we demonstrate the feasibility of second-harmonic generation (SHG) microscopy in the histopathological diagnosis of the liver of NAFLD patients for the quantitative assessment of the ultra-early stage of fibrosis. We investigated four representative NAFLD patients with early stages of fibrosis. SHG microscopy visualised well-matured fibrotic structures and early fibrosis diffusely involving liver tissues, whereas early fibrosis is challenging to be identified by conventional histopathological methods. Furthermore, the SHG emission directionality analysis revealed the maturation of each collagen fibre of each patient. As a result, SHG microscopy is feasible for assessing liver fibrosis on NAFLD patients, including the ultra-early stage of liver fibrosis that is difficult to diagnose by the conventional histopathological method. The assessment method of the ultra-early fibrosis by using SHG microscopy may serve as a crucial means for pathological, clinical, and prognostic diagnosis of NAFLD patients.

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Johannson, Kerri A., Eric Vittinghoff, Julie Morisset, Joyce S. Lee, John R. Balmes, and Harold R. Collard. "Home monitoring improves endpoint efficiency in idiopathic pulmonary fibrosis." European Respiratory Journal 50, no. 1 (July 2017): 1602406. http://dx.doi.org/10.1183/13993003.02406-2016.

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The objective of this study was to investigate the reliability, feasibility and analytical impact of home-based measurement of forced vital capacity (FVC) and dyspnoea as clinical endpoints in idiopathic pulmonary fibrosis (IPF).Patients with IPF performed weekly home-based assessment of FVC and dyspnoea using a mobile hand-held spirometer and self-administered dyspnoea questionnaires. Weekly variability in FVC and dyspnoea was estimated, and sample sizes were simulated for a hypothetical 24-week clinical trial using either traditional office-based interval measurement or mobile weekly assessment.In total, 25 patients were enrolled. Mean adherence to weekly assessments over 24 weeks was greater than 90%. Compared with change assessment using baseline and 24-week measurements only, weekly assessment of FVC resulted in enhanced precision and power. For example, a hypothetical 24-week clinical trial with FVC as the primary endpoint would require 951 patients using weekly home spirometry compared with 3840 patients using office spirometry measures at weeks 1 and 24 only. The ability of repeated measures to reduce clinical trial sample size was influenced by the correlation structure of the data.Home monitoring can improve the precision of endpoint assessments, allowing for greater efficiency in clinical trials of therapeutics for IPF.

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Pimpalwar, Yayati, and Akhilesh Rao. "Liver fibrosis assessment: a correlation of fibro scan values with gray scale assessment of portal vein." International Journal of Research in Medical Sciences 6, no. 1 (December 23, 2017): 317. http://dx.doi.org/10.18203/2320-6012.ijrms20175741.

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Background: FibroScan is an expensive modality with excellent accuracy for diagnosis of cirrhosis by measuring liver stiffness. In less developed countries it is not a financially viable method for fibrosis measurement. The aim of this study is to compare and correlate FibroScan values with gray scale sonographic assessment of portal vein calibre diameter which can be done using a basic ultrasonography machine.Methods: Prospective review of 124 patients with chronic liver disease done between Dec 2015 to May 2016 with the objective of correlating FibroScan values with gray scale assessment of portal vein.Results: In our study 50 patients had liver stiffness scores of > or = 7.5 kPa and above. A total of 45 patients had a respiratory phase variation of portal vein calibre of < 20%. Out of these, 37 patients had a liver stiffness score of 7.5 kPa or above. These 37 patients were correctly classified by portal vein calibre variability as having moderate to severe fibrosis. The results of this study revealed a significant correlation (Pearson coefficient, r = -0.617, p= 0.01) between calibre variation of the portal vein and FibroScan scores. We also noted that in presence of mild fibrosis as predicted by lower FibroScan scores, PV calibre variation is not a reliable indicator of mild fibrosis.Conclusions: We propose that, in less developed countries, gray scale assessment of portal vein diameter using any low cost ultrasound machine can be used as an optimal method for predicting moderate to severe liver fibrosis.

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Buzzetti, Elena, Rosa Lombardi, Laura De Luca, and Emmanuel A. Tsochatzis. "Noninvasive Assessment of Fibrosis in Patients with Nonalcoholic Fatty Liver Disease." International Journal of Endocrinology 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/343828.

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Nonalcoholic fatty liver disease (NAFLD) is prevalent in 20–25% of the general population and is associated with metabolic risk factors such as obesity, diabetes mellitus, and dyslipidemia. Histologically, NAFLD ranges from simple steatosis to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. As NASH develops in only 10–15% of patients with NAFLD, it is not practical to biopsy all patients who present with NAFLD. Noninvasive fibrosis tests have been extensively developed recently and offer alternatives for staging fibrosis. Despite their increasing use, such tests cannot adequately differentiate simple steatosis from NASH. At present, such tests can be used as first line tests to rule out patients without advanced fibrosis and thus prevent unnecessary secondary care referrals in a significant number of patients. In this review we present the evidence for the use of noninvasive fibrosis tests in patients with NAFLD.

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Ballestri, Stefano, Alessandro Mantovani, Maria Di Girolamo, Enrica Baldelli, Mariano Capitelli, and Amedeo Lonardo. "Liver fibrosis in nonalcoholic fatty liver disease patients: noninvasive evaluation and correlation with cardiovascular disease and mortality." Metabolism and Target Organ Damage 3, no. 1 (2023): 1. http://dx.doi.org/10.20517/mtod.2022.23.

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Liver fibrosis is critical for liver-related outcomes and mortality in chronic liver disease, irrespective of etiology, including nonalcoholic fatty liver disease (NAFLD). NAFLD has been viewed as an independent correlate of cardiovascular risk. This review article briefly describes the cellular and molecular pathomechanisms underlying hepatic fibrosis. We then address noninvasive assessment of liver fibrosis. Finally, we discuss published evidence supporting fibrosis biomarkers’ role in assessing cardiovascular risk among patients with NAFLD. While histological assessment is the diagnostic standard of hepatic fibrosis, we specifically address noninvasive techniques, including equations based on anthropometric parameters, laboratory indices, and elastometry obtained with imaging techniques. The former group includes AST: ALT ratio, the Forns Index, the AST-to-platelet ratio index score, BARD (BMI, AAR, Diabetes) score, the fibrosis-4 index (FIB-4), the NAFLD fibrosis score, the gamma-glutamyl transferase-to-platelet ratio, and the Hepamet fibrosis score. The latter comprises elastographic techniques associated with ultrasonography or magnetic resonance. Our literature review identified numerous studies demonstrating that biomarkers of fibrosis (the most common being FIB-4) and elastographic techniques predict overall mortality and major cardiovascular events among NAFLD patients. The mechanisms accounting for this association are briefly reviewed. In addition to assessing hepatic fibrosis at baseline, during follow-up, and after therapeutic interventions in NAFLD patients, noninvasive assessment of hepatic fibrosis may predict cardiovascular events and overall mortality in these patients.

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Soon, Gwyneth, and Aileen Wee. "Updates in the quantitative assessment of liver fibrosis for nonalcoholic fatty liver disease: Histological perspective." Clinical and Molecular Hepatology 27, no. 1 (January 1, 2021): 44–57. http://dx.doi.org/10.3350/cmh.2020.0181.

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Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) is a major cause of liver fibrosis and cirrhosis. Accurate assessment of liver fibrosis is important for predicting disease outcomes and assessing therapeutic response in clinical practice and clinical trials. Although noninvasive tests such as transient elastography and magnetic resonance elastography are preferred where possible, histological assessment of liver fibrosis via semiquantitative scoring systems remains the current gold standard. Collagen proportionate area provides more granularity by measuring the percentage of fibrosis on a continuous scale, but is limited by the absence of architectural input. Although not yet used in routine clinical practice, advances in second harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy imaging show great promise in characterising architectural features of fibrosis at the individual collagen fiber level. Quantification and calculation of different detailed variables of collagen fibers can be used to establish algorithm-based quantitative fibrosis scores (e.g., qFibrosis, q-FPs), which have been validated against fibrosis stage in NAFLD. Artificial intelligence is being explored to further refine and develop quantitative fibrosis scoring methods. SHG-microscopy shows promise as the new gold standard for the quantitative measurement of liver fibrosis. This has reaffirmed the pivotal role of the liver biopsy in fibrosis assessment in NAFLD, at least for the near-future. The ability of SHG-derived algorithms to intuitively detect subtle nuances in liver fibrosis changes over a continuous scale should be employed to redress the efficacy endpoint for fibrosis in NASH clinical trials; this approach may improve the outcomes of the trials evaluating therapeutic response to antifibrotic drugs.

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Petzold, Golo. "Role of Ultrasound Methods for the Assessment of NAFLD." Journal of Clinical Medicine 11, no. 15 (August 5, 2022): 4581. http://dx.doi.org/10.3390/jcm11154581.

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Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. The prevalence in patients with type 2 diabetes mellitus is between 55–80%. The spectrum of NALFD ranges from simple steatosis to aggressive steatohepatitis with potentially progressive liver fibrosis up to cirrhosis and hepatocellular carcinoma. In clinical practice, there are two important aims: First to make the diagnosis of NAFLD, and second, to identify patients with advanced fibrosis, because extent of fibrosis is strongly associated with overall mortality, cardiovascular disease, hepatocellular carcinoma, and extrahepatic malignancy. Histology by liver biopsy can deliver this information, but it is an invasive procedure with rare, but potentially severe, complications. Therefore, non-invasive techniques were developed to stage fibrosis. Ultrasound is the primary imaging modality in the assessment of patients with confirmed or suspected NAFLD. This narrative review focus on different ultrasound methods to detect and graduate hepatic steatosis and to determine grade of fibrosis using elastography-methods, such as transient elastography and 2-dimensional shear wave elastography in patients with NAFLD. Particular attention is paid to the application and limitations in overweight patients in clinical practice. Finally, the role of B-mode ultrasound in NAFLD patients to screen for hepatocellular carcinoma is outlined.

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Khallafi, Hicham, and Kamran Qureshi. "Imaging Based Methods of Liver Fibrosis Assessment in Viral Hepatitis: A Practical Approach." Interdisciplinary Perspectives on Infectious Diseases 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/809289.

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Liver fibrosis represents the repair mechanism in liver injury and is a feature of most chronic liver diseases. The degree of liver fibrosis in chronic viral hepatitis infections has major clinical implications and presence of advanced fibrosis or cirrhosis determines prognosis. Treatment initiation for viral hepatitis is indicated in most cases of advanced liver fibrosis and diagnosis of cirrhosis entails hepatology evaluation for specialized clinical care. Liver biopsy is an invasive technique and has been the standard of care of fibrosis assessment for years; however, it has several limitations and procedure related complications. Recently, several methods of noninvasive assessment of liver fibrosis have been developed which require either serologic testing or imaging of liver. Imaging based noninvasive techniques are reviewed here and their clinical use is described. Some of the imaging based tests are becoming widely available, and collectively they are shown to be superior to liver biopsy in important aspects. Clinical utilization of these methods requires understanding of performance and quality related parameters which can affect the results and provide wrong assessment of the extent of liver fibrosis. Familiarity with the strengths and weaknesses of each modality is needed to correctly interpret the results in appropriate clinical context.

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