Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography.

By M. Friedrich-Rust, Katrin Wunder, S. Kriener, Fariba Sotoudeh, Swantje Richter, J. Bojunga, E. Herrmann, T. Poynard, C. Dietrich, J. Vermehren and 2 more. Radiology, 2009

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PURPOSE To compare, in a pilot study, acoustic radiation force impulse (ARFI) imaging technology integrated into a conventional ultrasonography (US) system with both transient elastography (TE) and serologic fibrosis marker testing for the noninvasive assessment of liver fibrosis. MATERIALS AND METHODS Informed consent was obtained from all subjects, and the local ethics committee approved the study. ARFI imaging involved the mechanical excitation of tissue with use of short-duration acoustic pulses to generate localized displacements in tissue. The displacements resulted in shear-wave propagation, which was tracked by using US correlation-based methods and recorded in meters per second. Eighty-six patients with chronic viral hepatitis underwent TE, ARFI imaging, and serum fibrosis marker testing. Results were compared with liver biopsy findings, which served as the reference standard. RESULTS ARFI imaging (rho = 0.71), TE (rho = 0.73), and serum fibrosis marker test (rho = 0.66) results correlated significantly with histologic fibrosis stage (P < .001). Median ARFI velocities ranged from 0.84 to 3.83 m/sec. Areas under the receiver operating characteristic curve for the accuracy of ARFI imaging, TE, and serum fibrosis marker testing were 0.82, 0.84, and 0.82, respectively, for the diagnosis of moderate fibrosis (histologic fibrosis stage, > or = 2) and 0.91, 0.91, and 0.82, respectively, for the diagnosis of cirrhosis. CONCLUSION ARFI imaging is a promising US-based method for assessing liver fibrosis in chronic viral hepatitis, with diagnostic accuracy comparable to that of TE in this preliminary study. SUPPLEMENTAL MATERIAL http://radiology.rsnajnls.org/cgi/content/full/252/2/595/DC1.

Subfields: Epidemiology, Radiology, Nuclear Medicine and Imaging

View Paper: https://www.semanticscholar.org/paper/320f219c14d5f5a9353d04c1459eb413d3807ac4

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Citations in the corpus

Noninvasive assessment of liver fibrosis (2011, background): “Recent studies have shown excellent diagnostic accuracy in identifying significant fibrosis and cirrhosis in patients with various liver diseases.(26,27) Its inclusion in a conventional ultrasound machine may offer an advantage in some centers.”
Acoustic Radiation Force Elasticity Imaging in Diagnostic Ultrasound (2013, positive): “Early implementations of shear wave imaging systems in the liver have motivated the use of low frequency ARF excitations and the development of the Fibroscan® XL mechanical punch for TE methods in obese patients [58, 87, 89, 120, 121].”
EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography.Part 2: Clinical Applications (2013, positive): “The accuracy of ARFI for the assessment of liver fibrosis is similar to TE [42, 45, 46].”
Evolving challenges in hepatic fibrosis (2010, methodology): “ARFI utilizes a conventional ultrasound device, which makes the technology more readily available given the wide use of ultrasound”
WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 3: liver. (2015, methodology): “Lastly, negative results should not be neglected (Ferraioli et al. 2012a; Friedrich-Rust et al. 2009b).”
EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. (2015, background): “While many studies reported comparable results for both methods [167,174,179,191,192], some studies report better results for ARFI [172] and others better results for TE [168,174], respectively.”
EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version) (2017, methodology): “The reproducibility of SWS assessed by VTQ® was evaluated in 61 patients with chronic hepatopathies [104].”