P-65 CONCORDANCE OF FIB-4 WITH TRANSITION ELASTOGRAPHY IN THE DIAGNOSIS OF ADVANCED LIVER FIBROSIS

Introduction

Transient elastography (TE) and non-invasive scores such as FIB-4 are non-invasive methods to evaluate liver fibrosis.

Objectives

To evaluate the concordance between TE and FIB-4 in the diagnosis of advanced fibrosis.

Methods

Observational study. 185 patients (53 ± 14 years, 71.4% women) referred for TE (FibroScan, Echosens). The main indication was non-alcoholic fatty liver disease (46%). Fibrosis staging sections recommended by the manufacturer were used. Clinical data and laboratory tests performed in the 30 days prior to the study were recorded. FIB-4 cuts > 3.45 and <1.45 were used to include and exclude advanced fibrosis, respectively. Statistical analysis by proportion of agreement and kappa index.

Results

26 cases (14.1%) presented advanced fibrosis (F3-F4) according to TE. The proportion according to FIB-4 was 89%, with a kappa index of 0.43. 93.8% of the patients with FIB-4 without advanced fibrosis had a concordant TE evaluation (F0-F2). 59 cases (31.9%) obtained an indeterminate FIB-4 value, of which 52.5%, 30.5% and 17% corresponded to patients without fibrosis, significant fibrosis and advanced fibrosis according to TE, respectively.

Conclusion

There is a good concordance between FIB-4 and TE to rule out advanced fibrosis. The FIB-4 does not allow an adequate categorization of the degree of fibrosis in approximately one third of the cases.