Liver stiffness measurement using acoustic radiation force impulse (ARFI) elastography and effect of necroinflammation

Ki Tae Yoon, Sun Min Lim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang Hyub Han, Chae Yoon Chon, Mong Cho, Jun Woo Lee, Seung Up Kim

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Background: Acoustic radiation force impulse (ARFI) elastography can be used to assess the degree of liver fibrosis. Aim: We evaluated the performance of ARFI elastography in assessment of liver fibrosis and compared it with the performance of aspartate aminotransferase-to-platelet ratio index (APRI) and transient elastography with Fibroscan (FS). Methods: We prospectively analyzed 250 consecutive patients who underwent liver biopsy and ARFI from June 2010 to May 2011. Reliable FS values were obtained for 97 (38.8%) patients. Results: The mean age of patients (147 male and 103 female) was 46.6 years. Liver stiffness values obtained by use of ARFI elastography significantly correlated with histological fibrosis stage (R = 0.575, P< 0.001). Area under the receiver operating characteristics curves (AU-ROCs) of ARFI elastography for predicting significant fibrosis (≥F2) and cirrhosis (F4) was 0.74 (95% confidence interval [CI], 0.64-0.86, P = 0.001) and 0.79 (95% CI, 0.67-0.91, P = 0.001), respectively, and those for APRI were 0.69 (95% CI, 0.58-0.79, P = 0.001) and 0.76 (95% CI, 0.64-0.85, P < 0.001), respectively. The optimum cutoff values for ARFI elastography were 1.13 m/s for ≥F2 and 1.98 m/s for F4; these decreased to 1.09 m/s for ≥F2 and 1.81 m/s for F4 when 131 patients with normal alanine aminotransferase (ALT) were selected. In the sub-group of 97 patients with reliable FS values, the performance in predicting ≥F2 or F4 was equivalent between ARFI elastography and FS. Conclusions: ARFI elastography is a reliable surrogate marker of liver fibrosis, if its relationship with biochemical markers, for example ALT level, is taken into account.

Original languageEnglish
Pages (from-to)1682-1691
Number of pages10
JournalDigestive diseases and sciences
Volume57
Issue number6
DOIs
Publication statusPublished - 2012 Jun 1

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Elasticity Imaging Techniques
Acoustics
Radiation
Liver
Liver Cirrhosis
Confidence Intervals
Fibrosis
Alanine Transaminase
Blood Platelets
Biomarkers
Background Radiation
Aspartate Aminotransferases
Transaminases
ROC Curve
Biopsy

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

Cite this

@article{17636bdfd88c4f788e9127539fdafbe5,
title = "Liver stiffness measurement using acoustic radiation force impulse (ARFI) elastography and effect of necroinflammation",
abstract = "Background: Acoustic radiation force impulse (ARFI) elastography can be used to assess the degree of liver fibrosis. Aim: We evaluated the performance of ARFI elastography in assessment of liver fibrosis and compared it with the performance of aspartate aminotransferase-to-platelet ratio index (APRI) and transient elastography with Fibroscan (FS). Methods: We prospectively analyzed 250 consecutive patients who underwent liver biopsy and ARFI from June 2010 to May 2011. Reliable FS values were obtained for 97 (38.8{\%}) patients. Results: The mean age of patients (147 male and 103 female) was 46.6 years. Liver stiffness values obtained by use of ARFI elastography significantly correlated with histological fibrosis stage (R = 0.575, P< 0.001). Area under the receiver operating characteristics curves (AU-ROCs) of ARFI elastography for predicting significant fibrosis (≥F2) and cirrhosis (F4) was 0.74 (95{\%} confidence interval [CI], 0.64-0.86, P = 0.001) and 0.79 (95{\%} CI, 0.67-0.91, P = 0.001), respectively, and those for APRI were 0.69 (95{\%} CI, 0.58-0.79, P = 0.001) and 0.76 (95{\%} CI, 0.64-0.85, P < 0.001), respectively. The optimum cutoff values for ARFI elastography were 1.13 m/s for ≥F2 and 1.98 m/s for F4; these decreased to 1.09 m/s for ≥F2 and 1.81 m/s for F4 when 131 patients with normal alanine aminotransferase (ALT) were selected. In the sub-group of 97 patients with reliable FS values, the performance in predicting ≥F2 or F4 was equivalent between ARFI elastography and FS. Conclusions: ARFI elastography is a reliable surrogate marker of liver fibrosis, if its relationship with biochemical markers, for example ALT level, is taken into account.",
author = "Yoon, {Ki Tae} and Lim, {Sun Min} and Park, {Jun Yong} and Kim, {Do Young} and Ahn, {Sang Hoon} and Han, {Kwang Hyub} and Chon, {Chae Yoon} and Mong Cho and Lee, {Jun Woo} and Kim, {Seung Up}",
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Liver stiffness measurement using acoustic radiation force impulse (ARFI) elastography and effect of necroinflammation. / Yoon, Ki Tae; Lim, Sun Min; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang Hyub; Chon, Chae Yoon; Cho, Mong; Lee, Jun Woo; Kim, Seung Up.

In: Digestive diseases and sciences, Vol. 57, No. 6, 01.06.2012, p. 1682-1691.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Liver stiffness measurement using acoustic radiation force impulse (ARFI) elastography and effect of necroinflammation

AU - Yoon, Ki Tae

AU - Lim, Sun Min

AU - Park, Jun Yong

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Han, Kwang Hyub

AU - Chon, Chae Yoon

AU - Cho, Mong

AU - Lee, Jun Woo

AU - Kim, Seung Up

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Background: Acoustic radiation force impulse (ARFI) elastography can be used to assess the degree of liver fibrosis. Aim: We evaluated the performance of ARFI elastography in assessment of liver fibrosis and compared it with the performance of aspartate aminotransferase-to-platelet ratio index (APRI) and transient elastography with Fibroscan (FS). Methods: We prospectively analyzed 250 consecutive patients who underwent liver biopsy and ARFI from June 2010 to May 2011. Reliable FS values were obtained for 97 (38.8%) patients. Results: The mean age of patients (147 male and 103 female) was 46.6 years. Liver stiffness values obtained by use of ARFI elastography significantly correlated with histological fibrosis stage (R = 0.575, P< 0.001). Area under the receiver operating characteristics curves (AU-ROCs) of ARFI elastography for predicting significant fibrosis (≥F2) and cirrhosis (F4) was 0.74 (95% confidence interval [CI], 0.64-0.86, P = 0.001) and 0.79 (95% CI, 0.67-0.91, P = 0.001), respectively, and those for APRI were 0.69 (95% CI, 0.58-0.79, P = 0.001) and 0.76 (95% CI, 0.64-0.85, P < 0.001), respectively. The optimum cutoff values for ARFI elastography were 1.13 m/s for ≥F2 and 1.98 m/s for F4; these decreased to 1.09 m/s for ≥F2 and 1.81 m/s for F4 when 131 patients with normal alanine aminotransferase (ALT) were selected. In the sub-group of 97 patients with reliable FS values, the performance in predicting ≥F2 or F4 was equivalent between ARFI elastography and FS. Conclusions: ARFI elastography is a reliable surrogate marker of liver fibrosis, if its relationship with biochemical markers, for example ALT level, is taken into account.

AB - Background: Acoustic radiation force impulse (ARFI) elastography can be used to assess the degree of liver fibrosis. Aim: We evaluated the performance of ARFI elastography in assessment of liver fibrosis and compared it with the performance of aspartate aminotransferase-to-platelet ratio index (APRI) and transient elastography with Fibroscan (FS). Methods: We prospectively analyzed 250 consecutive patients who underwent liver biopsy and ARFI from June 2010 to May 2011. Reliable FS values were obtained for 97 (38.8%) patients. Results: The mean age of patients (147 male and 103 female) was 46.6 years. Liver stiffness values obtained by use of ARFI elastography significantly correlated with histological fibrosis stage (R = 0.575, P< 0.001). Area under the receiver operating characteristics curves (AU-ROCs) of ARFI elastography for predicting significant fibrosis (≥F2) and cirrhosis (F4) was 0.74 (95% confidence interval [CI], 0.64-0.86, P = 0.001) and 0.79 (95% CI, 0.67-0.91, P = 0.001), respectively, and those for APRI were 0.69 (95% CI, 0.58-0.79, P = 0.001) and 0.76 (95% CI, 0.64-0.85, P < 0.001), respectively. The optimum cutoff values for ARFI elastography were 1.13 m/s for ≥F2 and 1.98 m/s for F4; these decreased to 1.09 m/s for ≥F2 and 1.81 m/s for F4 when 131 patients with normal alanine aminotransferase (ALT) were selected. In the sub-group of 97 patients with reliable FS values, the performance in predicting ≥F2 or F4 was equivalent between ARFI elastography and FS. Conclusions: ARFI elastography is a reliable surrogate marker of liver fibrosis, if its relationship with biochemical markers, for example ALT level, is taken into account.

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