Comparison of acoustic radiation force impulse imaging with transient elastography for the detection of complications in patients with cirrhosis.
BACKGROUND
Acoustic radiation force impulse (ARFI) imaging is a new non-invasive, ultrasound-based method for the evaluation of liver fibrosis and cirrhosis.


OBJECTIVE
To determine the diagnostic accuracy of ARFI imaging, transient elastography (TE) and Fibrotest for the evaluation of complications in patients with cirrhosis.


METHODS
A total of 166 patients (109 male, mean age: 54 ± 11 years) with chronic liver disease and established cirrhosis were included in this study. ARFI-imaging of the liver and spleen, TE and Fibrotest were performed in all patients. In addition, clinical, laboratory and morphological parameters, including MELD/Child-Pugh scores, presence of oesophageal varices and hepatocellular carcinoma, history of variceal bleeding and history of hepatic encephalopathy were recorded.


RESULTS
Acoustic radiation force impulse liver was significantly correlated with ARFI spleen (r = 0.48, P < 0.001), TE (r = 0.75, P < 0.001) and Fibrotest (r = 0.21, P = 0.006). The diagnostic accuracy (AUROC) for the diagnosis of large oesophageal varices was 0.58 (95% CI: 0.48-0.67), 0.58 (0.49-0.67), 0.53 (0.44-0.63) and 0.50 (0.41-0.59) for ARFI liver, spleen, TE and Fibrotest respectively (P > 0.20). The AUROC for the detection of hepatocellular carcinoma (HCC) was 0.54 (0.39-0.70), 0.58 (0.44-0.73), 0.56 (0.40-0.73) and 0.72 (0.60-0.84) respectively (P > 0.20). Multiple logistic regression analysis showed that ARFI spleen better predicted the presence of large oesophageal varices and HCC compared with ARFI liver.


CONCLUSIONS
The diagnostic accuracy of ARFI liver and spleen was comparable to TE and Fibrotest for the detection of complications in patients with cirrhosis.
Medizinische Klinik 1, Klinikum der J. W. Goethe-Universität, Frankfurt am Main, Germany.
Johannes
J
Vermehren
Andreas
A
Polta
Olga
O
Zimmermann
Eva
E
Herrmann
Thierry
T
Poynard
Wolf-Peter
WP
Hofmann
Jörg
J
Bojunga
Christoph
C
Sarrazin
Stefan
S
Zeuzem
Mireen
M
Friedrich-Rust
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D054459:Elasticity Imaging Techniques / Q000379:methods*; D058625:End Stage Liver Disease / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic
D015415:Biomarkers; D011933:Reagent Kits, Diagnostic