Evaluation of Acoustic Radiation Force Impulse (ARFI) for Fibrosis Staging in Chronic Liver Diseases
Abstract: acoustic radiation
force impulse (ARFI) is a new proposed noninvasive method for liver fibrosis
staging. Integrated with B-mode ultrasonography, ARFI can be used to assess
liver tissue condition. However its diagnostic accuracy is still being
continuously evaluated. Also, there is lack of data regarding the utilization
of ARFI in our population. This study aimed to evaluate the diagnostic value of
ARFI as an alternative noninvasive modality for fibrosis staging in chronic
hepatitis B and hepatitis C patients in our population. Methods: we conducted
cross-sectional comparison of ARFI imaging and transient elastography on
patients who underwent liver biopsy at Cipto Mangunkusumo Hospital. Fibrosis
staging using METAVIR scoring system presented as standard reference. A total
of 43 patients underwent liver biopsy was evaluated by ARFI imaging and
transient elastography. Cut-off values were determined using receiver-operating
characteristic (ROC). Results: both liver stiffness determined by ARFI and
transient elastography (TE) were moderately correlated with METAVIR score with
value of 0.581 and 0.613, respectively (both P<0.01). Diagnostic accuracy of
ARFI predicted significant fibrosis (F≥2) with area under receiver operating
characteristic curve (AUROC) of 0.773 (95% CI 0.616-0.930) and even better for
cirrhosis (F4 fibrosis), expressed as AUROC of 0.856 (95% CI 0.736–0.975).
Transient elastography was better for significant fibrosis with AUROC of 0.761
(95% CI 0.601–0.920) and was best for prediction of cirrhosis, expressed as
AUROC of 0.845 (95% CI 0.722–0.968). Conclusion: ARFI is provided with more
convenient evaluation of liver tissue condition, and its diagnostic accuracy is
not significantly different from TE for staging liver fibrosis.
Keywords: acoustic radiation
force impulse (ARFI); fibrosis; transient elastography; liver biopsy
Author: Rino Alvani Gani,
Irsan Hasan, Andri Sanityoso, Cosmas Rinaldi A Lesmana, Juferdy Kurniawan,
Chyntia Olivia Maurine Jasirwan, Kemal Fariz Kalista, Lutfie Lutfie
Journal Code: jpkedokterangg170344
