{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:03:35Z","timestamp":1784937815638,"version":"3.55.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Liver fibrosis holds a relevant prognostic meaning in primary biliary cholangitis (PBC). Noninvasive fibrosis evaluation using vibration\u2010controlled transient elastography (VCTE) is routinely performed. However, there is limited evidence on its accuracy at diagnosis in PBC. We aimed to estimate the diagnostic accuracy of VCTE in assessing advanced fibrosis (AF) at disease presentation in PBC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>We collected data from 167 consecutive treatment\u2010na\u00efve PBC patients who underwent liver biopsy (LB) at diagnosis at six Italian centers. VCTE examinations were completed within 12\u00a0weeks of LB. Biopsies were scored by two blinded expert pathologists, according to the Ludwig system. Diagnostic accuracy was estimated using the area under the receiver operating characteristic curves (AUROCs) for AF (Ludwig stage\u00a0\u2265III). Effects of biochemical and clinical parameters on liver stiffness measurement (LSM) were appraised. The derivation cohort consisted of 126 patients with valid LSM and LB; VCTE identified patients with AF with an AUROC of 0.89. LSM cutoffs \u22646.5 and &gt;11.0\u00a0kPa enabled to exclude and confirm, respectively, AF (negative predictive value [NPV]\u00a0=\u00a00.94; positive predictive value [PPV]\u00a0=\u00a00.89; error rate\u00a0=\u00a05.6%). These values were externally validated in an independent cohort of 91 PBC patients (NPV\u00a0=\u00a00.93; PPV\u00a0=\u00a00.89; error rate\u00a0=\u00a08.6%). Multivariable analysis found that the only parameter affecting LSM was fibrosis stage. No association was found with BMI and liver biochemistry.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In a multicenter study of treatment\u2010na\u00efve PBC patients, we identified two cutoffs (LSM \u22646.5 and &gt;11.0\u00a0kPa) able to discriminate at diagnosis the absence or presence, respectively, of AF in PBC patients, with external validation. In patients with LSM between these two cutoffs, VCTE is not reliable and liver biopsy should be evaluated for accurate disease staging. BMI and liver biochemistry did not affect LSMs.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31810","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T09:14:30Z","timestamp":1615886070000},"page":"1496-1508","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":66,"title":["Accuracy of Transient Elastography in Assessing Fibrosis at Diagnosis in Na\u00efve Patients With Primary Biliary Cholangitis: A Dual Cut\u2010Off Approach"],"prefix":"10.1097","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9846-7474","authenticated-orcid":false,"given":"Laura","family":"Cristoferi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"},{"name":"Bicocca Bioinformatics Biostatistics and Bioimaging Centre\u2010B4,School of Medicine and Surgery,University of Milan\u2010Bicocca,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenza","family":"Calvaruso","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, PROMISE,University of Palermo,Palermo,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3561-8903","authenticated-orcid":false,"given":"Diletta","family":"Overi","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences,Sapienza University of Rome,Rome,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Vigan\u00f2","sequence":"additional","affiliation":[{"name":"Division of Hepatology,Ospedale San Giuseppe,University of Milan,Milan,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rigamonti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine,Universit\u00e0 degli Studi del Piemonte Orientale \u201cA. Avogadro\u201d,Novara,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9899-4669","authenticated-orcid":false,"given":"Elisabetta","family":"Degasperi","sequence":"additional","affiliation":[{"name":"CRC \u201cA. M. e A. Migliavacca\u201d Center for Liver Diseases, Division of Gastroenterology and Hepatology,Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico,University of Milan,Milan,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Department of Medico\u2010Surgical Sciences and Biotechnologies,Polo Pontino \u201cSapienza\u201d University of Rome,Latina,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Labanca","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine,University of Genoa,Genoa,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Zucchini","sequence":"additional","affiliation":[{"name":"Pathology Department,San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Fichera","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, PROMISE,University of Palermo,Palermo,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology and Hepatology, PROMISE,University of Palermo,Palermo,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Leutner","sequence":"additional","affiliation":[{"name":"Histopathology Unit,AOU Maggiore della Carit\u00e0,Novara,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Venere","sequence":"additional","affiliation":[{"name":"Department of Precision and Translational Medicine,Sapienza University of Rome,Rome,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Picciotto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine,University of Genoa,Genoa,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Luc\u00e0","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Mulinacci","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8057-9398","authenticated-orcid":false,"given":"Andrea","family":"Palermo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5086-0514","authenticated-orcid":false,"given":"Alessio","family":"Gerussi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"D\u2019Amato","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Elisabeth O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Cerini","sequence":"additional","affiliation":[{"name":"Division of Hepatology,Ospedale San Giuseppe,University of Milan,Milan,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"De Benedittis","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine,Universit\u00e0 degli Studi del Piemonte Orientale \u201cA. Avogadro\u201d,Novara,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Malinverno","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Ronca","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Mancuso","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Cazzagon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology,University of Padua,Padua,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Ciaccio","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Barisani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marzioni","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Universit\u00e0 Politecnica delle Marche,Ancona,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annarosa","family":"Floreani","sequence":"additional","affiliation":[{"name":"Studiosa Senior,University of Padua,Padua,Italy"},{"name":"Scientific Consultant,IRCCS Negrar,Verona,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Alvaro","sequence":"additional","affiliation":[{"name":"Department of Medico\u2010Surgical Sciences and Biotechnologies,Polo Pontino \u201cSapienza\u201d University of Rome,Latina,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Gaudio","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences,Sapienza University of Rome,Rome,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Invernizzi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8570-2519","authenticated-orcid":false,"given":"Guido","family":"Carpino","sequence":"additional","affiliation":[{"name":"Department of Movement, Human and Health Science,University of Rome \u201cForo Italico\u201d,Rome,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Nardi","sequence":"additional","affiliation":[{"name":"Department of Mathematics,University of Rome Tor Vergata,Rome,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Carbone","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology,Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on the behalf of the Italian PBC Registry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,5,28]]},"reference":[{"key":"hep31810-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1016\/S0140-6736(15)00154-3","article-title":"Primary biliary cirrhosis","volume":"386","year":"2015","journal-title":"Lancet"},{"key":"hep31810-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1053\/j.gastro.2015.07.061","article-title":"Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy","volume":"149","year":"2015","journal-title":"Gastroenterology"},{"key":"hep31810-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1002\/hep.28017","article-title":"The UK\u2010PBC risk scores: derivation and validation of a scoring system for long\u2010term prediction of end\u2010stage liver disease in primary biliary cholangitis","volume":"63","year":"2016","journal-title":"Hepatology"},{"key":"hep31810-bib-0004-20250824","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1053\/j.gastro.2012.12.005","article-title":"Sex and age are determinants of the clinical phenotype of primary biliary cirrhosis and response to ursodeoxycholic acid","volume":"144","year":"2013","journal-title":"Gastroenterology"},{"key":"hep31810-bib-0005-20250824","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/S2468-1253(18)30163-8","article-title":"Pretreatment prediction of response to ursodeoxycholic acid in primary biliary cholangitis: development and validation of the UDCA Response Score","volume":"3","year":"2018","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"hep31810-bib-0006-20250824","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1111\/apt.15533","article-title":"Fibrosis stage is an independent predictor of outcome in primary biliary cholangitis despite biochemical treatment response","volume":"50","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"hep31810-bib-0007-20250824","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/apt.15583","article-title":"Letter: histology is relevant for risk stratification in primary biliary cholangitis","volume":"51","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"hep31810-bib-0008-20250824","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1002\/hep.30145","article-title":"Primary biliary cholangitis: 2018 practice guidance from the American Association for the Study of Liver Diseases","volume":"69","year":"2019","journal-title":"Hepatology"},{"key":"hep31810-bib-0009-20250824","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jhep.2017.03.022","article-title":"EASL Clinical Practice Guidelines: the diagnosis and management of patients with primary biliary cholangitis","volume":"67","year":"2017","journal-title":"J Hepatol"},{"key":"hep31810-bib-0010-20250824","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1136\/gutjnl-2017-315259","article-title":"The British Society of Gastroenterology\/UK\u2010PBC primary biliary cholangitis treatment and management guidelines","volume":"67","year":"2018","journal-title":"Gut"},{"issue":"Suppl. 1","key":"hep31810-bib-0011-20250824","first-page":"71","article-title":"Guidelines for the management of primary biliary cirrhosis","volume":"44","year":"2014","journal-title":"Hepatol Res"},{"key":"hep31810-bib-0012-20250824","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1053\/j.gastro.2019.01.042","article-title":"Accuracy of FibroScan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease","volume":"156","year":"2019","journal-title":"Gastroenterology"},{"key":"hep31810-bib-0013-20250824","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1053\/j.gastro.2008.01.034","article-title":"Performance of transient elastography for the staging of liver fibrosis: a meta\u2010analysis","volume":"134","year":"2008","journal-title":"Gastroenterology"},{"key":"hep31810-bib-0014-20250824","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1002\/hep.25599","article-title":"Noninvasive elastography\u2010based assessment of liver fibrosis progression and prognosis in primary biliary cirrhosis","volume":"56","year":"2012","journal-title":"Hepatology"},{"key":"hep31810-bib-0015-20250824","article-title":"An updated list of essential items for reporting diagnostic accuracy studies","volume":"351","year":"2015","journal-title":"BMJ"},{"key":"hep31810-bib-0016-20250824","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","year":"2006","journal-title":"Hepatology"},{"key":"hep31810-bib-0017-20250824","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1053\/jhep.2003.50346","article-title":"A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C","volume":"38","year":"2003","journal-title":"Hepatology"},{"key":"hep31810-bib-0018-20250824","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/BF00432479","article-title":"Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis)","volume":"379","year":"1978","journal-title":"Virchows Arch A Pathol Anat Histol"},{"key":"hep31810-bib-0019-20250824","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1002\/hep.25993","article-title":"Determination of reliability criteria for liver stiffness evaluation by transient elastography","volume":"57","year":"2013","journal-title":"Hepatology"},{"key":"hep31810-bib-0020-20250824","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1016\/j.jhep.2014.01.029","article-title":"Optimising risk stratification in primary biliary cirrhosis: AST\/platelet ratio index predicts outcome independent of ursodeoxycholic acid response","volume":"60","year":"2014","journal-title":"J Hepatol"},{"key":"hep31810-bib-0021-20250824","first-page":"887","article-title":"Performance and utility of transient elastography and noninvasive markers of liver fibrosis in primary biliary cirrhosis","volume":"43","year":"2011","journal-title":"Dig Liver Dis"},{"key":"hep31810-bib-0022-20250824","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/j.1365-2036.2007.03585.x","article-title":"Transient elastography to assess hepatic fibrosis in primary biliary cirrhosis","volume":"27","year":"2008","journal-title":"Aliment Pharmacol Ther"},{"key":"hep31810-bib-0023-20250824","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1111\/j.1365-2036.2011.04722.x","article-title":"Dual cut\u2010off transient elastography to assess liver fibrosis in chronic hepatitis B: a cohort study with internal validation","volume":"34","year":"2011","journal-title":"Aliment Pharmacol Ther"},{"key":"hep31810-bib-0024-20250824","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1002\/hep.30825","article-title":"Evaluating noninvasive markers to identify advanced fibrosis by liver biopsy in HBV\/HIV co\u2010infected adults","volume":"71","year":"2020","journal-title":"Hepatology"},{"key":"hep31810-bib-0025-20250824","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/S2468-1253(19)30383-8","article-title":"FibroScan\u2010AST (FAST) score for the non\u2010invasive identification of patients with non\u2010alcoholic steatohepatitis with significant activity and fibrosis: a prospective derivation and global validation study","volume":"5","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"hep31810-bib-0026-20250824","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.cgh.2012.01.015","article-title":"Levels of alanine aminotransferase confound use of transient elastography to diagnose fibrosis in patients with chronic hepatitis C virus infection","volume":"10","year":"2012","journal-title":"Clin Gastroenterol Hepatol"},{"key":"hep31810-bib-0027-20250824","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/j.1365-2893.2006.00811.x","article-title":"Transient elastography: a new surrogate marker of liver fibrosis influenced by major changes of transaminases","volume":"14","year":"2007","journal-title":"J Viral Hepat"},{"key":"hep31810-bib-0028-20250824","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1111\/j.1478-3231.2008.01743.x","article-title":"Disproportionally high results of transient elastography in patients with autoimmune hepatitis","volume":"28","year":"2008","journal-title":"Liver Int"},{"key":"hep31810-bib-0029-20250824","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1002\/hep.22200","article-title":"Transient elastography in acute hepatitis: all that\u2019s stiff is not fibrosis","volume":"47","year":"2008","journal-title":"Hepatology"},{"key":"hep31810-bib-0030-20250824","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1002\/hep.22056","article-title":"Transient elastography is unreliable for detection of cirrhosis in patients with acute liver damage","volume":"47","year":"2008","journal-title":"Hepatology"},{"key":"hep31810-bib-0031-20250824","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1002\/hep.22007","article-title":"Acute viral hepatitis increases liver stiffness values measured by transient elastography","volume":"47","year":"2008","journal-title":"Hepatology"},{"key":"hep31810-bib-0032-20250824","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1038\/ajg.2015.139","article-title":"Long\u2010term prognostic significance of persisting histological activity despite biochemical remission in autoimmune hepatitis","volume":"110","year":"2015","journal-title":"Am J Gastroenterol"},{"key":"hep31810-bib-0033-20250824","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1097\/MCG.0b013e318154af74","article-title":"Serologic markers compared with liver biopsy for monitoring disease activity in autoimmune hepatitis","volume":"42","year":"2008","journal-title":"J Clin Gastroenterol"},{"key":"hep31810-bib-0034-20250824","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.jhep.2017.11.020","article-title":"Usefulness of biochemical remission and transient elastography in monitoring disease course in autoimmune hepatitis","volume":"68","year":"2018","journal-title":"J Hepatol"},{"key":"hep31810-bib-0035-20250824","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.jhep.2016.05.023","article-title":"Transient elastography in autoimmune hepatitis: timing determines the impact of inflammation and fibrosis","volume":"65","year":"2016","journal-title":"J Hepatol"},{"key":"hep31810-bib-0036-20250824","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1002\/hep.22577","article-title":"Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosis","volume":"48","year":"2008","journal-title":"Hepatology"},{"key":"hep31810-bib-0037-20250824","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1053\/j.gastro.2013.12.030","article-title":"Baseline values and changes in liver stiffness measured by transient elastography are associated with severity of fibrosis and outcomes of patients with primary sclerosing cholangitis","volume":"146","year":"2014","journal-title":"Gastroenterology"},{"key":"hep31810-bib-0038-20250824","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1148\/radiol.2016160685","article-title":"Diagnostic performance of MR elastography and vibration\u2010controlled transient elastography in the detection of hepatic fibrosis in patients with severe to morbid obesity","volume":"283","year":"2017","journal-title":"Radiology"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep.31810","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep.31810","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/hep.31810","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T23:13:00Z","timestamp":1756077180000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/hep.31810"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,28]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.31810","relation":{},"ISSN":["0270-9139","1527-3350"],"issn-type":[{"value":"0270-9139","type":"print"},{"value":"1527-3350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,28]]},"assertion":[{"value":"2020-11-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}