Welcome to the Echosens Clinical Library, the database to find the most relevant clinical evidences in the field of hepatology related to FibroScan® and FibroMeter®.
Clinical Commissioning Policy Statement: Treatment of chronic Hepatitis C in patients with cirrhosis
"POLICY STATEMENT: Treatment of chronic Hepatitis C in patients with cirrhosis Commissioning position: The regimens set out in the table below will be commissioned as an alternative to current therapies when the following apply: For patients with compensated cirrhosis:
1) Treatments are provided to the NHS under a commercial-in-confidence scheme AND
2) The patient has compensated cirrhosis defined as:
- Evidence of portal hypertension without other obvious cause (e.g. varices on endoscopy or previous ascites in the absence of vascular lesions known to cause portal hypertension), OR
- APRI score and AST:ALT ratio indicative of cirrhosis (APRI >2.0 with an AST:ALT ratio > 1), OR
- Imaging (Ultrasound or CT or MRI) reported as showing cirrhosis. OR
- Fibro Scan or liver elastography showing evidence of cirrhosis (for example, a Fibro Scan score of >11.5kPa, or as determined by an expert panel if required), OR
- Liver biopsy showing cirrhosis [...]"
Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension
"Screening and surveillance: Invasive and non-invasive methods (changed from Baveno III-V) Definition of compensated advanced chronic liver disease (new)
- The introduction of transient elastography (TE) in clinical practice has allowed the early identification of patients with chronic liver disease (CLD) at risk of developing clinically significant portal hypertension (CSPH) (1b;A).
Criteria to suspect cACLD (new)
- Liver stiffness by TE is sufficient to suspect cACLD in asymptomatic subjects with known causes of CLD (1b;A).
- TE often has false positive results; hence two measurements on different days are recommended in fasting conditions (5;D).
- TE values 15 kPa are highly suggestive of cACLD (1b;A). Diagnosis of CSPH in patients with cACLD (new) - In patients with virus related cACLD non-invasive methods are sufficient to rule-in CSPH, defining the group of patients at risk of having endoscopic signs of PH.
The following can be used (2b;B):
- Liver stiffness by TE (P20-25 kPa; at least two measurements on different days in fasting condition; caution should be paid to flares of ALT; refer to EASL guidelines for correct interpretation criteria), alone or combined to platelets and spleen size.
- The diagnostic value of TE for CSPH in other aetiologies remains to be ascertained (5;D). Identification of patients with cACLD who can safely avoid screening endoscopy (new)
- Patients with a liver stiffness 150,000 have a very low risk of having varices requiring treatment, and can avoid screening endoscopy (1b;A).
- These patients can be followed up by yearly repetition of TE and platelet count (5;D).
- If liver stiffness increases or platelet count declines, these patients should undergo screening esophagogastroduodenoscopy (5;D). Extrahepatic portal vein obstruction (EHPVO) Diagnosis (changed from Baveno V)
- Liver biopsy and HVPG are recommended, if the liver is dysmorphic on imaging or liver tests are persistently abnormal, to rule out cirrhosis or idiopathic non-cirrhotic portal hypertension (1b;B). Liver stiffness by TE may be useful to exclude cirrhosis (5;D)."
[Webinar] Echosens Webinar on Combined LSM and CAP Testing in Fatty Liver Patients
Echosens Webinar on Combined LSM and CAP Testing in Fatty Liver Patients 54:30
Echosens Webinar on Combined LSM and CAP Testing in Fatty Liver Patients
Speakers: Dr. Vuppalanchi
Early evidence of the clinical utility of LSM + CAP will be provided and case studies will be presented.
Following a 45 minute didactic session, participants will have the opportunity to ask questions.
Guideline on HCV diagnosis and treatment
"Confirmative diagnosis Confirmative diagnosis for chronic HCV:
- Anti HCV positive, HCV RNA positive;
- Duration of infection > 6 months, or fibrosis phenomenon (identified by APRI indicator or liver biopsy shows imagine of chronic hepatitis and meaningful tendinitis stenosans or FibroScan, Fibrotest shows fibrosis > F2) other than any other origin (Appendix 1) APPENDIX 1 Interpretation of Tests FibroScan F0: 1-5kPa F1: 5-7kPa F2: 7.1-8.6kPa F3: 8.7-14.5kPa F4: > 14.6kPa APPENDIX 2 Prior
-Treatment Evaluation Test - Assessment of Cirrhosis status (liver biopsy, or Fibrotest, or Fibroscan, or APRI) [...]."