title: Acoustic Radiation Force Impulse elastography for fibrosis evaluation in patients with chronic hepatitis C: an international multicenter study.
abstract: OBJECTIVE
  The aim of this international multicenter study was to evaluate the reliability of Acoustic Radiation Force Impulse (ARFI) elastography for predicting fibrosis severity, in patients with chronic hepatitis C.
  
  
  METHODS
  We compared ARFI to liver biopsy (LB) in 914 patients (10 centers, 5 countries) with chronic hepatitis C. In each patient LB (evaluated according to the METAVIR score) and ARFI measurements were performed (median of 5-10 valid measurements, expressed in meters/second - m/s). In 400 from the 914 patients, transient elastography (TE) was also performed (median of 6-10 valid measurements, expressed in kiloPascals - kPa).
  
  
  RESULTS
  Valid ARFI measurements were obtained in 911 (99.6%) of 914 cases. On LB 61 cases (6.7%) had F0, 241 (26.4%) had F1, 202 (22.1%) had F2, 187 (20.4%) had F3, and 223 (24.4%) had F4 fibrosis. A highly significant correlation (r=0.654) was found between ARFI measurements and fibrosis (p<0.0001). The predictive values of ARFI for various stages of fibrosis were: F ≥ 1 - cut-off>1.19 m/s (AUROC=0.779), F ≥ 2 - cut-off>1.33 m/s (AUROC=0.792), F ≥ 3 - cut-off>1.43 m/s (AUROC=0.829), F=4 - cut-off>1.55 m/s (AUROC=0.842). The correlation with histological fibrosis was not significantly different for TE in comparison with ARFI elastography: r=0.728 vs. 0.689, p=0.28. TE was better than ARFI for predicting the presence of liver cirrhosis (p=0.01) and fibrosis (F ≥ 1, METAVIR) (p=0.01).
  
  
  CONCLUSIONS
  ARFI elastography is a reliable method for predicting fibrosis severity in chronic hepatitis C patients.
authors.affiliation: Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania. isporea@umft.ro
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.forename: Simona
authors.initials: S
authors.lastname: Bota
authors.forename: Markus
authors.initials: M
authors.lastname: Peck-Radosavljevic
authors.forename: Roxana
authors.initials: R
authors.lastname: Sirli
authors.forename: Hironori
authors.initials: H
authors.lastname: Tanaka
authors.forename: Hiroko
authors.initials: H
authors.lastname: Iijima
authors.forename: Radu
authors.initials: R
authors.lastname: Badea
authors.forename: Monica
authors.initials: M
authors.lastname: Lupsor
authors.forename: Carmen
authors.initials: C
authors.lastname: Fierbinteanu-Braticevici
authors.forename: Ana
authors.initials: A
authors.lastname: Petrisor
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Saito
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ebinuma
authors.forename: Mireen
authors.initials: M
authors.lastname: Friedrich-Rust
authors.forename: Christoph
authors.initials: C
authors.lastname: Sarrazin
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Naofumi
authors.initials: N
authors.lastname: Ono
authors.forename: Fabio
authors.initials: F
authors.lastname: Piscaglia
authors.forename: Alberto
authors.initials: A
authors.lastname: Borghi
authors.forename: Mirko
authors.initials: M
authors.lastname: D'Onofrio
authors.forename: Anna
authors.initials: A
authors.lastname: Gallotti
authors.forename: Arnulf
authors.initials: A
authors.lastname: Ferlitsch
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.forename: Mirela
authors.initials: M
authors.lastname: Danila
mesh_terms: D015897:Comorbidity; D054459:Elasticity Imaging Techniques / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D038622:Internationality; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity