Clinical usefulness and performance of acoustic radiation force impulse in patients with chronic hepatitis B.
OBJECTIVE
The aim of this study was to evaluate the performance of acoustic radiation force impulse (ARFI) compared with liver biopsy in quantifying fibrosis levels in patients with chronic hepatitis B (CHB).


METHODS
The study was approved by the institutional review board at our hospital. One hundred CHB patients and 30 healthy controls (130 individuals) were included in the study. ARFI measurements were performed on all of these cases. CHB was diagnosed when serum hepatitis surface antigen was positive for more than 6 months and when persistent or intermittent elevations in alanine aminotransferase and aspartate aminotransferase levels and histopathological changes in liver biopsy were present. Liver biopsies were taken as a reference standard for 100 CHB patients. Liver biopsy samples were examined using the Ishak scoring system and compared with ARFI velocity values.


RESULTS
Of the 130 participants, 107 (82.3%) were men and 23 (17.7%) were women. Thirty of these participants were healthy controls and their fibrotic score was evaluated as an Ishak fibrosis score of 0. A gradual increase in the mean velocity value was obtained for fibrosis scores F0-F6 (Ishak fibrosis score) in our study. A strong positive correlation was found between the mean velocity values and fibrosis scores of liver biopsy that were performed on liver segment 8. The area under the receiver operating characteristic curve was used to detect the best cutoff velocity values, and no or mild fibrosis (F≤2), significant fibrosis (F≥3), and severe fibrosis (F≥5) were calculated to be 0.95, 1.75, and 2.55 m/s, respectively. When a cutoff value of 1.75 m/s was used, ARFI had a sensitivity of 83% and a specificity of 98% in differentiating patients with fibrosis score F≤2 versus F≥3.


CONCLUSIONS
ARFI elastography in patients with CHB can be considered an easy-to-use and accurate noninvasive tool to evaluate the severity of liver fibrosis.
aDepartment of Radiology, Canakkale State Hospital, Canakkale bDepartment of Infectious Diseases and Clinical Microbiology, Van Training and Research Hospital, Van cDepartment of Radiology, Kasimpasa Military Hospital dDepartment of Radiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey.
Coskun
C
Ozturker
Ergenekon
E
Karagoz
Ali K
AK
Sivrioglu
Kemal
K
Kara
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D016022:Case-Control Studies; D054459:Elasticity Imaging Techniques; D005240:Feasibility Studies; D005260:Female; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D055815:Young Adult