The Indian Journal of Pediatrics

, Volume 85, Issue 11, pp 1037–1039 | Cite as

Evaluating Liver Fibrosis by Acoustic Radiation Force Impulse in Thalassemia

  • Rashid H. Merchant
  • Mubaraka Lokhandwala
  • Pezad N. DoctorEmail author
  • Chandar P. Lulla
  • Bhavin Jankharia
Scientific Letter

To the Editor: Acoustic radiation force impulse (ARFI) is an ultrasound-based elastography technique used to evaluate tissue stiffness by virtual touch tissue quantification using a conventional probe [1]. ARFI results strongly correlate with the stage of fibrosis in chronic liver disease, and it, therefore, promises to replace liver biopsy [2]. There are very few studies both internationally and in India that have evaluated the use of ARFI scan in thalassemic population [3].

A cross-sectional, non-interventional, observational study of 84 thalassemia major patients, between 8 and 18 y of age, was performed at a tertiary hospital in Mumbai from January through December 2016. Liver stiffness was assessed on a Siemens Accuson S 3000 ARFI machine using a 2.67 MHz probe, and shear velocity were documented in meters per second (m/s). Liver stiffness measurements were taken by the same person (radiologist) to minimize inter-observer variabilities. 3 Tesla MRI T2* imaging was used for iron...



ARFI and MRI scans were sponsored by THINK Foundation, an NGO working for Thalassemia.

Compliance with Ethical Standards

Conflict of Interest



  1. 1.
    D’Onofrio M, Crosara S, De Robertis R, et al. Acoustic radiation force impulse of the liver. World J Gastroenterol. 2013;19:4841–9.CrossRefGoogle Scholar
  2. 2.
    Haque M, Robinson C, Owen D, Yoshida EM, Harris A. Comparison of acoustic radiation force impulse imaging (ARFI) to liver biopsy histologic scores in the evaluation of chronic liver disease: a pilot study. Ann Hepatol. 2010;9:289–93.PubMedGoogle Scholar
  3. 3.
    Shivaraja A, Hegde P, Bukelo MJ, Kumar PS, Basti RS. Virtual touch tissue quantification of liver in thalassemia. Int J Contemp Pediatr. 2015;2:415–8.Google Scholar
  4. 4.
    Colombo S, Buonocore M, Del Poggio A, et al. Head-to-head comparison of transient elastography (TE), real-time tissue elastography (RTE), and acoustic radiation force impulse (ARFI) imaging in the diagnosis of liver fibrosis. J Gastroenterol. 2012;47:461–9.CrossRefGoogle Scholar
  5. 5.
    Pipaliya N, Solanke D, Parikh P, et al. Comparison of tissue elastography with magnetic resonance imaging T2* and serum ferritin quantification in detecting liver iron overload in patients with thalassemia major. Clin Gastroenterol Hepatol. 2017;15:292–8.CrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  • Rashid H. Merchant
    • 1
  • Mubaraka Lokhandwala
    • 1
  • Pezad N. Doctor
    • 1
    Email author
  • Chandar P. Lulla
    • 2
  • Bhavin Jankharia
    • 3
  1. 1.Department of PediatricsNanavati Super Speciality HospitalMumbaiIndia
  2. 2.Ria ClinicMumbaiIndia
  3. 3.Jankharia Imaging and Diagnostics CentreMumbaiIndia

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