title: How useful are ARFI elastography cut-off values proposed by meta-analysis for predicting the significant fibrosis and compensated liver cirrhosis?
abstract: OBJECTIVE
  To evaluate how often do we "miss" chronic hepatitis C patients with at least significant fibrosis (F&gt;/=2) and those with compensated cirrhosis, by using Acoustic Radiation Force Impulse (ARFI) elastography cut-off values proposed by meta-analysis.
  
  
  METHODS
  Our study included 132 patients with chronic hepatitis C, evaluated by means of ARFI and liver biopsy (LB), in the same session. Reliable measurements were defined as: median value of 10 liver stiffness (LS) measurements with a success rate&gt;/=60% and an interquartile range interval&lt;30%. For predicting F&gt;/=2 and F=4 we used the LS cut-offs proposed in the last published meta-analysis: 1.35 m/s and 1.87 m/s, respectively.
  
  
  RESULTS
  Reliable LS measurements by means of ARFI were obtained in 117 patients (87.9%). In our study, 58 patients (49.6%) had LS values &lt;1.35 m/s; from these 75.8% had F&gt;/=2 in LB. From the 59 patients (50.4%) with LS values&gt;/=1.35 m/s, only 6.8% had F0 or F1 in LB. Also, in our study, 88 patients (75.3%) had LS values &lt;1.87 m/s; from these only 2.2 % had F4 in LB. From the 29 patients (24.7%) with LS values&gt;/=1.87 m/s, 41.3% had F4 in LB. Both for prediction of at least significant fibrosis and liver cirrhosis, higher aminotransferases levels were associated with wrongly classified patients, in univariate and multivariate analysis.
  
  
  CONCLUSIONS
  ARFI elastography had a very good positive predictive value (93.2%) for predicting the presence of significant fibrosis and excellent negative predictive value (97.8%) for excluding the presence of compensated liver cirrhosis.
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania. bota_simona1982@yahoo.com.
authors.forename: Simona
authors.initials: S
authors.lastname: Bota
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania.
authors.forename: Roxana
authors.initials: R
authors.lastname: Sirli
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, Romania.
authors.forename: Oana
authors.initials: O
authors.lastname: Gradinaru-Tascau
mesh_terms: D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult