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Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse: comparison with Fibroscan®

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Accurate evaluation of liver fibrosis in patients with chronic liver damage is required to determine the appropriate treatment. Various approaches, including laboratory tests and transient elastography, have been used to evaluate liver fibrosis. Recently, transient elastography with acoustic radiation force impulse (ARFI) has been developed and applied with conventional ultrasonography. The aim of this study was to evaluate the clinical utility of transient elastography with ARFI and to compare the results with this method and those of the Fibroscan® procedure.

Methods

One hundred and thirty-one patients with liver damage, who underwent liver biopsy at our department, were enrolled prospectively in this study. Elastography with ARFI (applied with ACUSON S2000®), and Fibroscan® was performed at the same time as liver biopsy. These measurements were compared with histological findings in liver biopsy specimens, and measurement accuracy was evaluated by receiver-operating characteristic analysis.

Results

Elastography values with both procedures were significantly correlated with the stages of liver fibrosis and there was little difference in the results obtained using the 2 procedures. The accuracy of differential diagnosis between no fibrosis at F0 and more than F1 stage was insufficient with ARFI, but this procedure was sufficient for diagnosing advanced fibrosis. The accuracy of ARFI was almost equivalent to that of the Fibroscan® method. Moreover, both ARFI and Fibroscan® values increased in proportion to the severity of hepatic inflammation when fibrosis stage is low, but not in proportion to the severity of steatosis.

Conclusions

Transient elastography with ARFI is simple, non-invasive and useful for diagnosing the stage of fibrosis in chronic liver disease. The utility of ARFI was almost equivalent to that of the Fibroscan® method.

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Abbreviations

ARFI:

Acoustic radiation force impulse

HCC:

Hepatocellular carcinoma

US:

Ultrasonography

ROI:

Region of interest

ROC:

Receiver operating characteristic

AUROC:

Area under ROC curve

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan

    Hirotoshi Ebinuma, Hidetsugu Saito, Keisuke Ojiro, Kanji Wakabayashi, Shingo Usui, Po-sung Chu, Rumiko Umeda, Yuka Ishibashi, Tetsurou Takayama, Masahiro Kikuchi, Nobuhiro Nakamoto, Yoshiyuki Yamagishi, Takanori Kanai & Toshifumi Hibi

  2. Department of Internal Medicine, School of Medicine and Faculty of Pharmacy, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hidetsugu Saito

  3. Department of Pathology, School of Medicine, Keio University, Tokyo, Japan

    Mina Komuta & Michiie Sakamoto

  4. Department of Diagnostic Radiology, School of Medicine, Keio University, Tokyo, Japan

    Kiyoshi Ohkuma

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  1. Hirotoshi Ebinuma
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Correspondence to Hidetsugu Saito.

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Ebinuma, H., Saito, H., Komuta, M. et al. Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse: comparison with Fibroscan® . J Gastroenterol 46, 1238–1248 (2011). https://doi.org/10.1007/s00535-011-0437-3

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  • DOI: https://doi.org/10.1007/s00535-011-0437-3

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