title: Non-invasive evaluation of cystic fibrosis related liver disease in adults with ARFI, transient elastography and different fibrosis scores.
abstract: BACKGROUND
  Cystic fibrosis-related liver disease (CFLD) is present in up to 30% of cystic fibrosis patients and can result in progressive liver failure. Diagnosis of CFLD is challenging. Non-invasive methods for staging of liver fibrosis display an interesting diagnostic approach for CFLD detection.
  
  
  OBJECTIVE
  We evaluated transient elastography (TE), acoustic radiation force impulse imaging (ARFI), and fibrosis indices for CFLD detection.
  
  
  METHODS
  TE and ARFI were performed in 55 adult CF patients. In addition, AST/Platelets-Ratio-Index (APRI), and Forns' score were calculated. Healthy probands and patients with alcoholic liver cirrhosis served as controls.
  
  
  RESULTS
  Fourteen CF patients met CFLD criteria, six had liver cirrhosis. Elastography acquisition was successful in >89% of cases. Non-cirrhotic CFLD individuals showed elastography values similar to CF patients without liver involvement. Cases with liver cirrhosis differed significantly from other CFLD patients (ARFI: 1.49 vs. 1.13 m/s; p = 0.031; TE: 7.95 vs. 4.16 kPa; p = 0.020) and had significantly lower results than individuals with alcoholic liver cirrhosis (ARFI: 1.49 vs. 2.99 m/s; p = 0.002). APRI showed the best diagnostic performance for CFLD detection (AUROC 0.815; sensitivity 85.7%, specificity 70.7%).
  
  
  CONCLUSIONS
  ARFI, TE, and laboratory based fibrosis indices correlate with each other and reliably detect CFLD related liver cirrhosis in adult CF patients. CF specific cut-off values for cirrhosis in adults are lower than in alcoholic cirrhosis.
authors: University Hospital Leipzig, Department of Internal Medicine, Dermatology and Neurology, Medical Clinic for Gastroenterology and Rheumatology, Leipzig, Germany.
authors: Thomas
authors: T
authors: Karlas
authors: Marie
authors: M
authors: Neuschulz
authors: Annett
authors: A
authors: Oltmanns
authors: Andrea
authors: A
authors: Güttler
authors: David
authors: D
authors: Petroff
authors: Hubert
authors: H
authors: Wirtz
authors: Jochen G
authors: JG
authors: Mainz
authors: Joachim
authors: J
authors: Mössner
authors: Thomas
authors: T
authors: Berg
authors: Michael
authors: M
authors: Tröltzsch
authors: Volker
authors: V
authors: Keim
authors: Johannes
authors: J
authors: Wiegand
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male