title: Acoustic Radiation Force Impulse (ARFI) and Transient Elastography (TE) for evaluation of liver fibrosis in HIV-HCV co-infected patients.
abstract: BACKGROUND
  Transient elastography (TE) is widely used for non-invasive assessment of liver fibrosis in HIV-HCV co-infected patients. TE, however, cannot determine liver morphology. Acoustic radiation force impulse (ARFI) imaging is a novel procedure enabling assessment of liver fibrosis during a conventional ultrasonographic examination. This study evaluated the correlation between liver fibrosis measurements by TE and ARFI.
  
  
  METHODS
  Each of 46 HIV-HCV patients underwent both ARFI and TE within 6 months. Patients were evaluated by the "equivalent METAVIR" scoring system, using previously established cut-off values. Agreements between the ARFI and TE scores were estimated by Kappa coefficients, with Kappa values ≥0.40, ≥0.60, and ≥0.80 defined as moderate, good and very good agreement, respectively.
  
  
  RESULTS
  ARFI and TE yielded "Equivalent Metavir" fibrosis scores of F1 in 26 and 31 patients, respectively; F2 in nine and seven, respectively; F3 in three and two, respectively; and F4 in eight and six, respectively. The two methods showed very good agreement in predicting overall stages [Kappa = 0.82] and for F ≥3 [Kappa = 0.80] and moderate agreement in predicting significant fibrosis F ≥2 [Kappa = 0.50]. Morphologic ultrasound analysis concomitant to ARFI detected two hepatocarcinomas.
  
  
  CONCLUSIONS
  ARFI showed promising results in the non-invasive assessment of liver fibrosis in HIV-HCV patients, with liver fibrosis staging similar to that of TE. Moreover, ARFI can assess morphology and fibrosis during the same session.
authors.affiliation: Department of Diagnostic and Interventional Imaging, Saint-André hospital, CHU de Bordeaux, 1 rue Jean Burguet, 33075 Bordeaux, France. norafrulio@yahoo.fr.
authors.forename: Nora
authors.initials: N
authors.lastname: Frulio
authors.forename: Hervé
authors.initials: H
authors.lastname: Trillaud
authors.forename: Paul
authors.initials: P
authors.lastname: Perez
authors.forename: Julien
authors.initials: J
authors.lastname: Asselineau
authors.forename: Marianne
authors.initials: M
authors.lastname: Vandenhende
authors.forename: Mojgan
authors.initials: M
authors.lastname: Hessamfar
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bonnet
authors.forename: Florent
authors.initials: F
authors.lastname: Maire
authors.forename: Jean
authors.initials: J
authors.lastname: Delaune
authors.forename: Victor
authors.initials: V
authors.lastname: De Ledinghen
authors.forename: Philippe
authors.initials: P
authors.lastname: Morlat
mesh_terms: D000328:Adult; D060085:Coinfection; D054459:Elasticity Imaging Techniques; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000473:pathology*; D016174:Hepacivirus; D006526:Hepatitis C / Q000150:complications / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged