title: Non-invasive assessment of liver fibrosis with impulse elastography: comparison of Supersonic Shear Imaging with ARFI and FibroScan®.
abstract: OBJECTIVE
  Non-invasive assessment of liver fibrosis by elastography is a rapidly developing field with frequent technological innovations. The aim of this study was to assess the diagnostic performances of Supersonic Shear Imaging (SSI) for the diagnosis of liver fibrosis in chronic liver disease.
  
  
  METHODS
  A total of 349 consecutive patients with chronic liver diseases who underwent liver biopsy from November 2011 to October 2013 were prospectively enrolled. For each patient, liver stiffness was assessed by SSI, ARFI, FibroScan® (M probe for patients with BMI <30 kg/m(2), and XL probe for patients with BMI ⩾30 kg/m(2)), performed within two weeks of liver biopsy. Areas under the receiver operating curves (AUROCs) were performed and compared for each degree of liver fibrosis.
  
  
  RESULTS
  SSI, FibroScan®, and ARFI correlated significantly with histological fibrosis score (r=0.79, p<0.00001; r=0.70, p<0.00001; r=0.64, p<0.00001, respectively). AUROCs of SSI, FibroScan®, and ARFI were 0.89, 0.86, and 0.84 for the diagnosis of mild fibrosis; 0.88, 0.84, and 0.81 for the diagnosis of significant fibrosis; 0.93, 0.87, and 0.89, for the diagnosis of severe fibrosis; 0.93, 0.90, and 0.90 for the diagnosis of cirrhosis, respectively. SSI had a higher accuracy than FibroScan® for the diagnosis of severe fibrosis (⩾F3) (p=0.0016), and a higher accuracy than ARFI for the diagnosis of significant fibrosis (⩾F2) (p=0.0003). No significant difference was observed for the diagnosis of mild fibrosis and cirrhosis.
  
  
  CONCLUSIONS
  SSI is an efficient method for the assessment of liver fibrosis in chronic liver diseases, comparing favourably to FibroScan® and ARFI.
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France; INSERM U1053, Université Bordeaux, Bordeaux, France. Electronic address: christophe.cassinotto@chu-bordeaux.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Cassinotto
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lapuyade
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Amaury
authors.initials: A
authors.lastname: Mouries
authors.affiliation: Centre d'investigation de la fibrose hépatique, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Hiriart
authors.affiliation: Centre d'investigation de la fibrose hépatique, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Vergniol
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Gaye
authors.affiliation: Department of Pathology, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Place Amélie Raba-léon, 33000 Bordeaux, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Castain
authors.affiliation: INSERM U1053, Université Bordeaux, Bordeaux, France; Department of Pathology, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Place Amélie Raba-léon, 33000 Bordeaux, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Le Bail
authors.affiliation: Centre d'investigation de la fibrose hépatique, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Faiza
authors.initials: F
authors.lastname: Chermak
authors.affiliation: Centre d'investigation de la fibrose hépatique, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Foucher
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpîtal Haut-Lévêque, CHU and University of Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: François
authors.initials: F
authors.lastname: Laurent
authors.affiliation: Department of Diagnostic and Interventional Imaging, Hôpîtal Haut-Lévêque, CHU and University of Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Montaudon
authors.affiliation: INSERM U1053, Université Bordeaux, Bordeaux, France; Centre d'investigation de la fibrose hépatique, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, 1 Avenue de Magellan, 33604 Pessac, France.
authors.forename: Victor
authors.initials: V
authors.lastname: De Ledinghen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D003952:Diagnostic Imaging / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000201:enzymology / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Cirrhosis; Elasticity imaging techniques; Liver disease; Non-invasive diagnosis; Transient elastography; Ultrasonography