From the Guidelines
Fibroscan has a sensitivity of 88% for detecting liver cirrhosis, as reported in the most recent and highest quality study 1. The sensitivity of Fibroscan for liver cirrhosis is a critical parameter in assessing its effectiveness as a non-invasive diagnostic tool.
- The study published in 2025 1 provides the most up-to-date and reliable evidence on this topic, superseding earlier studies.
- According to this study, a liver stiffness measurement (LSM) cutoff value of 13 kPa yields a sensitivity of 88% and a specificity of 94% for detecting cirrhosis (F4) in patients with HCV.
- It is essential to note that the sensitivity and specificity of Fibroscan may vary depending on the underlying liver disease and patient population.
- For example, the study also reports that for HCV/HIV coinfection, a TE-LSM cutoff value of 14 kPa had a sensitivity of 83%–100% and a specificity of 84%–93% for detecting cirrhosis (F4) 1.
- In comparison, an earlier study published in 2017 1 reported a sensitivity of 87% and a specificity of 91% for diagnosing cirrhosis (F4) using TE, but this study is less recent and may not reflect the current state of evidence.
- Another study published in 2017 1 evaluated the use of VCTE vs FIB-4 for diagnosing cirrhosis in adults with NAFLD and reported a sensitivity of 0.90 for VCTE, but this study focused on a different patient population and may not be directly applicable to the question at hand.
- Overall, the most recent and highest quality study 1 provides the best evidence for the sensitivity of Fibroscan in detecting liver cirrhosis.
From the Research
Sensitivity of Fibroscan to Liver Cirrhosis
- The sensitivity of Fibroscan (Transient Elastography) to liver cirrhosis has been evaluated in several studies 2, 3, 4, 5, 6.
- A study published in 2021 found that the optimal cut-off values for liver cirrhosis diagnosis using FibroScan were 8.85,11.75, and 8.70 kPa, with accuracy rates of 78.7%, 78.4%, and 79.2%, respectively 2.
- Another study published in 2006 found that the area under the receiver operating characteristic curve (AUROC) for the diagnosis of cirrhosis using FibroScan was 0.95, with a cutoff value of 14.6 kPa having a positive predictive value of 74% and a negative predictive value of 96% 3.
- A 2012 study found that the optimal cut-off value for predicting liver cirrhosis using acoustic radiation force impulse imaging (ARFI) was 1.60 m/s, with a sensitivity of 92.3% and a specificity of 96.5% 4.
- A 2006 study published in the journal Gut found that using a cut-off value of 17.6 kPa, patients with cirrhosis were detected with a positive predictive value and a negative predictive value (NPV) of 90% 5.
- A 2015 study found that Fibroscan was moderately accurate in diagnosing grade I esophageal varices and less accurate in diagnosing grades II and III varices in all cirrhotic patients, irrespective of the underlying etiology 6.
Optimal Cut-off Values
- The optimal cut-off values for liver cirrhosis diagnosis using FibroScan vary across studies, ranging from 8.70 to 17.6 kPa 2, 3, 5.
- A cutoff value of 16.9 kPa was 83.8% sensitive in diagnosing esophageal varices in non-viral-cirrhotic patients, whereas a cutoff value of 19.9 kPa was 83.4% sensitive in diagnosing esophageal varices in patients with viral hepatitis 6.