Correlation of liver imaging and transient elastography among patients with hepatitis C at a safety net hospital

Table 1 Demographics of patients with chronic hepatitis C virus with transient elastography, n (%)

Variables	Patients (n = 959)
Age (years), mean ± SD	64.05 ± 9.81
Gender
Male	622 (64.9)
Female	337 (35.1)
Race
African American	780 (81.3)
White	146 (15.2)
Hispanic	16 (1.7)
Asian	4 (0.4)
American Indian and Alaskan Native	3 (0.3)
BMI (kg/m²), mean ± SD	27.13 ± 5.89
BMI categories
< 25	365 (38.1)
25-30	326 (34)
30-35	163 (17)
35-40	79 (8.2)
> 40	26 (2.7)
Alcohol consumption	305 (49)
Comorbidities
CAD	89 (9.3)
Hypertension	669 (69.8)
Dyslipidemia	303 (31.6)
Obesity	202 (21.1)
Fibrosis score	6.9 (5.4-9.8)
CAP score, mean ± SD	222.86 ± 52.29
Steatosis severity1
S0	630 (69.7)
S1	56 (6.2)
S2	79 (8.7)
S3	139 (15.4)
Fibrosis assessment
F0-F1	500 (52.1)
F2	212 (22)
F3	71 (7.4)
F4	177 (18.5)
Labs
AST (IU/L)	30 (21-49)
ALT (IU/L)	16 (25-43)
HbA1c (%), mean ± SD	6.58 ± 1.92
Total bilirubin (mg/dL)	0.6 (0.4-0.8)
Platelet (103 /μL), mean ± SD	219.64 ± 84.68
Albumin (g/dL)	4.06 ± 0.45

¹Denominator for steatosis severity is 904 as 55 patients did not have complete controlled attenuation parameter scores.

BMI: Body mass index; CAD: Coronary artery disease; CAP: Controlled attenuation parameter; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; HBA1c: Hemoglobin A1C.

Table 2 Correlation of imaging findings with controlled attenuation parameter score and liver stiffness measurement

Imaging findings	CAP score	LSM
Abnormal liver	r = 0.127, P < 0.001	r = 0.471, P < 0.001
Cirrhosis	r = -0.021, P = 0.527	r = 0.279, P < 0.001
Hepatic steatosis	r = 0.21, P < 0.001	r = 0.133, P < 0.001
Chronic liver disease	r = 0.03, P = 0.364	r = 0.42, P < 0.001
Increased echogenicity	r = 0.189, P < 0.001	r = 0.176, P < 0.001

CAP: Controlled attenuation parameter; LSM: Liver stiffness measurement.

Table 3 Association between abnormal liver imaging and fibrosis staging in hepatitis C

Variables	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	LR (+)	LR (-)
Abnormal liver finding
≥ F4	81.70	70.40	48.20	92.00	2.76	0.26
≥ F3	75.20	75.10	62.20	84.70	3.02	0.33
≥ F2	55.70	77.30	79.10	53.10	2.45	0.57
Cirrhosis
≥ F4	18.30	99.20	88.20	78.30	22.87	0.82
≥ F3	13.90	99.50	94.10	67.90	27.8	0.87
≥ F2	8.60	100.00	100.00	41.50	Inf	0.91
Hepatic steatosis
≥ F4	15.20	92.00	39.10	76.30	1.9	0.92
≥ F3	13.90	92.40	50.00	66.30	1.83	0.93
≥ F2	11.60	93.00	71.90	40.50	1.66	0.95
Suggestive of chronic liver disease
≥ F4	59.80	84.00	55.70	86.10	3.74	0.48
≥ F3	51.70	86.50	67.60	76.60	3.83	0.56
≥ F2	37.50	89.10	84.10	48.00	3.44	0.7
Increased echogenicity
≥ F4	17.10	90.30	37.30	76.40	1.76	0.92
≥ F3	18.30	92.20	56.00	67.40	2.35	0.89
≥ F2	14.20	92.60	74.70	41.10	1.92	0.93

PPV: Positive predictive value; NPV: Negative predictive value; LR: Likelihood ratio; Inf: Infinite.

Table 4 Association between abnormal liver imaging and steatosis staging in hepatitis C

Variables	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	LR (+)	LR (-)
Abnormal liver finding
≥ S3	56.10	60.40	24.30	85.90	1.42	0.73
≥ S2	53.30	61.40	34.20	77.70	1.38	0.76
≥ S1	51.50	61.30	38.10	73.20	1.33	0.79
Cirrhosis
≥ S3	3.50	94.60	12.90	81.20	0.65	1.02
≥ S2	3.60	94.40	19.40	72.20	0.64	1.02
≥ S1	3.90	94.20	23.50	67.90	0.67	1.02
Hepatic steatosis
≥ S3	24.60	93.00	44.40	84.50	3.53	0.81
≥ S2	20.10	93.50	54.00	75.60	3.11	0.85
≥ S1	18.00	93.90	57.80	71.20	2.95	0.87
Suggestive of chronic liver disease
≥ S3	28.10	73.40	19.30	81.80	1.05	0.98
≥ S2	26.00	72.80	26.50	72.30	0.96	1.02
≥ S1	26.20	72.60	30.70	68.00	0.96	1.02
Increased echogenicity
≥ S3	24.60	91.30	38.90	84.20	2.81	0.83
≥ S2	23.10	92.60	54.20	76.10	3.13	0.83
≥ S1	20.90	92.80	57.30	71.70	2.9	0.85

PPV: Positive predictive value; NPV: Negative predictive value; LR: Likelihood ratio.