title: Performance of Acoustic Radiation Force Impulse imaging for the staging of liver fibrosis: a pooled meta-analysis.
abstract: Acoustic Radiation Force Impulse (ARFI) imaging is a novel ultrasound-based elastography method that is integrated in a conventional ultrasound machine enabling the exact localization of measurement site. It might present an alternative method to transient elastography for the noninvasive assessment of liver fibrosis. At present, studies with small patient population have shown promising results. A systematic review and meta-analysis of pooled patient data were performed to evaluate the overall performance of ARFI for the staging of liver fibrosis. Literature databases were searched up to 10/2010. The authors of the original publication were contacted, and the original patient data were requested. A meta-analysis was performed using a random effect meta-analytic method for diagnostic tests. In addition, available data comparing ARFI with FibroScan with the DeLong test were evaluated. Literature search yielded nine full-paper publications evaluating ARFI while using liver biopsy as reference method. Original patient data were available from eight studies including 518 patients. The mean diagnostic accuracy of ARFI expressed as areas under ROC curves (AUROC) was 0.87 for the diagnosis of significant fibrosis (F ≥ 2), 0.91 for the diagnosis of severe fibrosis (F ≥ 3), and 0.93 for the diagnosis of cirrhosis. ARFI can be performed with good diagnostic accuracy for the noninvasive staging of liver fibrosis.
authors.affiliation: Department of Internal Medicine 1, JW Goethe-University Hospital, Frankfurt, Germany. Mireen.Friedrich-Rust@kgu.de
authors.forename: M
authors.initials: M
authors.lastname: Friedrich-Rust
authors.forename: J
authors.initials: J
authors.lastname: Nierhoff
authors.forename: M
authors.initials: M
authors.lastname: Lupsor
authors.forename: I
authors.initials: I
authors.lastname: Sporea
authors.forename: C
authors.initials: C
authors.lastname: Fierbinteanu-Braticevici
authors.forename: D
authors.initials: D
authors.lastname: Strobel
authors.forename: H
authors.initials: H
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Yoneda
authors.forename: T
authors.initials: T
authors.lastname: Suda
authors.forename: S
authors.initials: S
authors.lastname: Zeuzem
authors.forename: E
authors.initials: E
authors.lastname: Herrmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D055815:Young Adult