{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:31:22Z","timestamp":1787923882813,"version":"build-2784847793"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"10","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Turkish Journal of Gastroenterology"],"abstract":"<jats:p>Background\/Aims: The role of semi-quantitative strain ratio (SR) using real-time endoscopic ultrasound strain elastography (EUS-E) in chronic liver disease (CLD) and cirrhosis is yet to be determined. Herein, the aim was to assess the usefulness of EUS-E to detect CLD and cirrhosis.\nMaterials and Methods: Patients with cirrhosis and non-cirrhotic CLD were enrolled prospectively. Patients without liver disease and undergoing EUS examinations for non-hepatic indications were taken as control group. Strain ratio was calculated from strains of hepatic vein and liver parenchyma. Fibrosis-4 (FIB-4) and aspartate aminotransferase (AST)-to-Platelet Ratio Index (APRI) scores were recorded, and blood cytokeratin-18 (CK-18) levels were measured to assess hepatic fibrosis. A clinical evaluation was also conducted.\nResults: One hundred participants (control: 49, CLD: 33, cirrhotic: 18) were included. The SR and liver parenchyma strains in cirrhotics were significantly higher than those in the CLD (P &lt; .001) and control (P &lt; .001) groups. Strain ratio threshold set at 5.67 had a sensitivity of 94.4% and a specificity of 95.9% to differentiate cirrhotics from control patients. An SR threshold of 10.65 had a sensitivity of 94.4% and a specificity of 84.8% in differentiating cirrhotics from CLD patients. The SR showed a strong positive correlation with FIB-4 and APRI scores, but not with CK-18 levels.\nConclusions: Strain ratio thresholds of 5.67 and 10.65 obtained by EUS-E are useful to differentiate cirrhotics from non-cirrhotic CLD patients and liver-disease-free subjects, respectively. This pilot study is the first one evaluating the role of EUS-E in liver diseases, and future studies involving patients having CLD of specific etiologies are warranted.\n\u00a0\nCite this article as: Duman DG, Alahdab YO, Demirtas CO, et al. Usefulness of endoscopic ultrasound strain elastography for measuring liver stiffness and the role of blood cytokeratin 18 levels as a surrogate marker of fibrosis. Turk J Gastroenterol. 2025;36(10):692-699.<\/jats:p>","DOI":"10.5152\/tjg.2025.24070","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T10:50:26Z","timestamp":1758279026000},"page":"692-699","source":"Crossref","is-referenced-by-count":1,"title":["Usefulness of Endoscopic Ultrasound Strain Elastography for  Measuring Liver Stiffness and the Role of Blood Cytokeratin  18 Levels as a Surrogate Marker of Fibrosis"],"prefix":"10.5152","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5362-208X","authenticated-orcid":false,"given":"Deniz Guney","family":"Duman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1337-9254","authenticated-orcid":false,"given":"Yesim Ozen","family":"Alahdab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0004-2740","authenticated-orcid":false,"given":"Coskun Ozer","family":"Demirtas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4518-5283","authenticated-orcid":false,"given":"Yusuf","family":"Y\u0131lmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2901-7044","authenticated-orcid":false,"given":"Feyza","family":"Dilber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6144-5220","authenticated-orcid":false,"given":"Filiz Ture","family":"Ozdemir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6304-5554","authenticated-orcid":false,"given":"Caglayan","family":"Keklikkiran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0042-9256","authenticated-orcid":false,"given":"Haluk Tarik","family":"Kani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3639-1264","authenticated-orcid":false,"given":"Umut Emre","family":"Aykut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman Cavit","family":"Ozdogan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3111","published-online":{"date-parts":[[2025,6,16]]},"container-title":["Turkish Journal of Gastroenterology"],"original-title":[],"link":[{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/download\/4279\/3939","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/download\/4279\/3939","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:52:39Z","timestamp":1787921559000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.turkjgastroenterol.org\/index.php\/tjg\/article\/view\/4279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":0,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,15]]}},"URL":"https:\/\/doi.org\/10.5152\/tjg.2025.24070","relation":{},"ISSN":["2148-5607"],"issn-type":[{"value":"2148-5607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]}}}