Document Detail

Acoustic radiation force impulse: a new ultrasonographic technology for the widespread noninvasive diagnosis of liver fibrosis.
MedLine Citation:
PMID:  20440210     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: As a module of a standard ultrasound imaging device, acoustic radiation force impulse (ARFI) is a new technology for liver stiffness evaluation (LSE). We aimed to evaluate accuracy, feasibility, reproducibility, and training effect of ARFI for liver fibrosis evaluation.
METHODS: One hundred and one patients with chronic liver disease had LSE by Fibroscan and ARFI. LSE by ARFI was performed in the two liver lobes by two operators: an expert and a novice. Correlation and agreement were evaluated by the Pearson (Rp) and intraclass (Ric) correlation coefficients. The independent reference for liver fibrosis was fibrosis blood tests.
RESULTS: ARFI results, ranging from 0.7 to 4.6 m/s, were well correlated with Fibroscan results (Rp=0.76). Fibroscan had a significantly higher area under the receiver operating characteristic curve (AUROC) than ARFI for the perprotocol diagnosis of significant fibrosis: 0.890+/-0.034 versus 0.795+/-0.047 (P=0.04). However, LSE failure occurred in zero patients using ARFI versus six patients using Fibroscan (P=0.03). Thus, on an intention-to-diagnose basis, Fibroscan and ARFI AUROCs for the diagnosis of significant fibrosis were not different: 0.791+/-0.049 versus 0.793+/-0.046 (P=0.98). Interobserver agreement was very good (Ric=0.84) and excellent for ARFI interquartile range (IQR)< or =0.30 (Ric=0.91). Indeed, agreement was independently predicted only by ARFI IQR, but not by LSE result as earlier observed for Fibroscan. ARFI AUROC was 0.876+/-0.057 in patients with ARFI IQR ratio< or =0.30, and Fibroscan AUROC was 0.912+/-0.034 in patients with Fibroscan IQR ratio less than 0.21 (P=0.59). Intersite ARFI agreement between the two liver lobes was fair (Ric=0.60). There was no training effect for LSE by ARFI.
CONCLUSION: ARFI is highly feasible and reproducible, and provides diagnostic accuracy similar to Fibroscan. This new device seems noteworthy for the widespread noninvasive diagnosis of liver fibrosis.
Jérôme Boursier; Gael Isselin; Isabelle Fouchard-Hubert; Frédéric Oberti; Nina Dib; Jérôme Lebigot; Sandrine Bertrais; Yves Gallois; Paul Calès; Christophe Aubé
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Validation Studies    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  22     ISSN:  1473-5687     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-05     Completed Date:  2010-11-16     Revised Date:  2011-02-02    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1074-84     Citation Subset:  IM    
Departments of aHepato-gastroenterology bRadiology cBiochemistry, CHU dHIFIH laboratory, Angers University, PRES UNAM, Angers, France.
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MeSH Terms
Elasticity Imaging Techniques / methods*,  standards*,  statistics & numerical data
Inservice Training
Liver / ultrasonography*
Liver Cirrhosis / ultrasonography*
Middle Aged
Observer Variation
Radiology / education
Reproducibility of Results
Comment In:
Eur J Gastroenterol Hepatol. 2010 Nov;22(11):1387   [PMID:  20948383 ]

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