Acoustic Radiation Force Impulse (ARFI) Elastography for non‑invasive evaluation of hepatic fibrosis in chronic hepatitis B and C patients: a systematic review and meta-analysis.
OBJECTIVE
The purpose of the study was to assess the effect of Acoustic Radiation Force Impulse (ARFI) elastography in the diagnosis of liver fibrosis in chronic hepatitis B and C patients through Meta-analysis.


METHODS
Four databases (PubMed, the Cochrane Library, WanFang data, and CNKI) were searched. The key words were: ("ARFI" or "acoustic radiation force impulse") combined with "liver fibrosis" and ("chronic hepatitis" or "HBV HCV"). Heterogeneity (I2) was assessed, and its source was analyzed through meta-regression.


RESULTS
21 articles with 2,691 patients were included. The compositeSe=0.79 (95% CI: 0.76-0.83) and Sp=0.86 (95% CI: 0.85-0.88). ARFI elastography showed a better ability to evaluate higherstage liver fibrosis and liver cirrhosis (F=3 and F=4, respectively). For F≥3, Se=0.84 (95% CI: 0.80-0.88, I2=61.37), Sp=0.90 (95% CI: 0.86-0.92, I2=65.10), and AUROC=0.94 (95% CI: 0.91-0.95). Se and Sp and AUROC of F=4 were 0.86 (95% CI: 0.80-0.91, I2=70.67), 0.84 (95% CI: 0.80-0.88, I2=78.94) and 0.91 (95% CI: 0.89-0.94), respectively. Besides, the combined RFI values indicate that CHC patients had higher ARFI values especially in the F3 stage (1.87 [95% CI: 1.67-2.06] and 2.31[95% CI: 2.09-2.52] for CHB and CHC, respectively).


CONCLUSIONS
ARFI elastography is accurate and reliable in the diagnosis of CHB- and CHC-induced liver fibrosis and is especially suitable for the evaluation of stages F≥3 and F=4. CHC patients manifest higher ARFI values than CHB patients especially in the F3 stage.
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Xiangdong
X
Hu
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Lanyan
L
Qiu
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Dong
D
Liu
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China. qianlinxue_2016@163.com.
Linxue
L
Qian
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results