“CORRELATION OF HISTOPATHOLOGICAL GRADING AND RADIOLOGICAL STAGING IN HEPATIC FIBROSIS: A CROSS-SECTIONAL STUDY USING ULTRASOUND ELASTOGRAPHY AND METAVIR SCORING”
Main Article Content
Keywords
Hepatic fibrosis, METAVIR score, Ultrasound elastography, Liver stiffness, Chronic liver disease, Non-invasive fibrosis assessment.
Abstract
Background: Hepatic fibrosis is a progressive pathological condition associated with chronic liver disease, which can advance to cirrhosis and hepatocellular carcinoma if not diagnosed early. While liver biopsy remains the gold standard for staging fibrosis, it is invasive and carries procedural risks. Ultrasound elastography has emerged as a promising non-invasive modality for assessing liver stiffness, offering a potential alternative to histological examination.
Aim: To assess the correlation between radiological staging of hepatic fibrosis using ultrasound elastography and histopathological grading using the METAVIR scoring system.
Methods: A cross-sectional observational study was conducted at a tertiary care hospital in Vadodara, Gujarat, from November 2020 to November 2021. Sixty patients with chronic liver disease who underwent both liver biopsy and ultrasound elastography were included. Elastography values were measured in kilopascals (kPa), and histological grading was done using the METAVIR system. Statistical analysis was performed using Spearman’s rank correlation, ROC analysis, and diagnostic accuracy calculations.
Results: A strong positive correlation (r = 0.846, p < 0.001) was observed between elastography values and METAVIR scores. The optimal elastography cut-off of 7.1 kPa yielded 100% sensitivity and specificity for detecting significant fibrosis (≥F2). The area under the ROC curve (AUC) was 1.00, indicating excellent diagnostic performance. Substantial agreement was found between radiological and pathological staging (κ = 0.78).
Conclusion: Ultrasound elastography demonstrates excellent correlation with histopathological grading and can be a reliable, non-invasive tool for fibrosis staging in chronic liver disease. It may reduce the need for liver biopsy, especially in resource-limited settings, and improve early diagnosis and patient management.
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Amee Ashwinkumar Patel
Junior Resident, Microbiology Department, GMERS Medical College and Hospital, Vadnagar 2, Parth Bunglows, Dharoi Coloni road, Near Bansal mall, Visnagar- 384315 Contact No- +91 8469331117
Akshaykumar Sureshbhai Patel
Consultant, Radiology Department, Sub District Hospital, Unjha