title: Acoustic radiation force impulse-imaging and transient elastography for non-invasive assessment of liver fibrosis and steatosis in NAFLD.
abstract: BACKGROUND
  Transient elastography (TE) and acoustic radiation force impulse (ARFI)-imaging have shown promising results for the staging of liver fibrosis.
  
  
  OBJECTIVE
  The aim of the present study was to compare ARFI of the left and right liver lobe with TE using the standard and obese probes for the diagnosis of liver fibrosis in NAFL/NASH. In addition, liver steatosis is evaluated using the novel controlled attenuation parameter (CAP).
  
  
  METHODS
  Sixty-one patients with NAFLD/NASH were included in the study. All patients received TE with both probes, ARFI of both liver lobes and CAP. The results were compared with liver histology.
  
  
  RESULTS
  57 patients were included in the final analysis. The diagnostic accuracy for TE measurements with the M-and XL-probe and for ARFI of the right and left liver lobe was 0.73, 0.84, 0.71 and 0.60 for the diagnosis of severe fibrosis, and 0.93, 0.93, 0.74 and 0.90 for the diagnosis of cirrhosis, respectively. No significant difference of results was observed between TE and ARFI in the subgroup of patients with reliable TE-measurement when taking into account the best results of both methods. However, while a significant correlation could be found for TE with histological liver fibrosis, the correlation of ARFI with liver fibrosis was not statistically significant. A significant correlation was found for CAP with histological steatosis (r=0.49, p<0.001).
  
  
  CONCLUSIONS
  No significant difference in diagnostic accuracy for the non-invasive assessment of liver fibrosis was found for transient elastography and ARFI. Nevertheless TE significantly correlated with liver fibrosis while ARFI did not. CAP enables the non-invasive assessment of steatosis.
authors: Department of Internal Medicine, J.W. Goethe-University Hospital, and Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J.W. Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. Mireen.Friedrich-Rust@kgu.de
authors: Mireen
authors: M
authors: Friedrich-Rust
authors: Daniela
authors: D
authors: Romen
authors: Johannes
authors: J
authors: Vermehren
authors: Susanne
authors: S
authors: Kriener
authors: Dilek
authors: D
authors: Sadet
authors: Eva
authors: E
authors: Herrmann
authors: Stefan
authors: S
authors: Zeuzem
authors: Joerg
authors: J
authors: Bojunga
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012372:ROC Curve