title: Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse: comparison with Fibroscan(®).
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.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ebinuma
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Saito
authors.forename: Mina
authors.initials: M
authors.lastname: Komuta
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ojiro
authors.forename: Kanji
authors.initials: K
authors.lastname: Wakabayashi
authors.forename: Shingo
authors.initials: S
authors.lastname: Usui
authors.forename: Po-sung
authors.initials: PS
authors.lastname: Chu
authors.forename: Rumiko
authors.initials: R
authors.lastname: Umeda
authors.forename: Yuka
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Tetsurou
authors.initials: T
authors.lastname: Takayama
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Nakamoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamagishi
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ohkuma
authors.forename: Michiie
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index