Original Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 28, 2009; 15(44): 5525-5532
Published online Nov 28, 2009. doi: 10.3748/wjg.15.5525
Acoustic radiation force imaging sonoelastography for noninvasive staging of liver fibrosis
Carmen Fierbinteanu-Braticevici, Dan Andronescu, Radu Usvat, Dragos Cretoiu, Cristian Baicus, Gabriela Marinoschi
Carmen Fierbinteanu-Braticevici, Dan Andronescu, Radu Usvat, Medical Clinic II and Gastroenterology, University Hospital, 050094 Bucharest, Romania
Dragos Cretoiu, Department of Cellular and Molecular Medicine, “Carol Davila” University of Medicine and Pharmacy, 050094 Bucharest, Romania
Cristian Baicus, Department of Internal Medicine and Réseau d’Epidémiologie Clinique International Francophone (RECIF), Colentina Hospital, 020125 Bucharest, Romania
Gabriela Marinoschi, Institute of Mathematical Statistics and Applied Mathematics, 050711 Bucharest, Romania
Author contributions: Fierbinteanu-Braticevici C supervised the whole study and edited the manuscript; Andronescu D and Usvat R collected the data and reviewed the manuscript; Cretoiu D completed the searches; Baicus C performed the statistical analysis and reviewed the manuscript; Marinoschi G participated in the statistical analysis.
Supported by Grant 41066/2007, financed by the Ministry of Education and Research
Correspondence to: Carmen Fierbinteanu-Braticevici, Associate Professor, Medical Clinic II and Gastroenterology, University Hospital, Splaiul Independentei 169, 050094 Bucharest, Romania. cfierbinteanu@yahoo.com
Telephone: +40-21-3180571 Fax: +40-21-3180571
Received: August 12, 2009
Revised: September 14, 2009
Accepted: September 21, 2009
Published online: November 28, 2009
Abstract

AIM: To investigate the diagnostic accuracy of acoustic radiation force impulse (ARFI) imaging as a noninvasive method for the assessment of liver fibrosis in chronic hepatitis C (CHC) patients.

METHODS: We performed a prospective blind comparison of ARFI elastography, APRI index and FibroMax in a consecutive series of patients who underwent liver biopsy for CHC in University Hospital Bucharest. Histopathological staging of liver fibrosis according to the METAVIR scoring system served as the reference. A total of 74 patients underwent ARFI elastography, APRI index, FibroMax and successful liver biopsy.

RESULTS: The noninvasive tests had a good correlation with the liver biopsy results. The most powerful test in predicting fibrosis was ARFI elastography. The diagnostic accuracy of ARFI elastography, expressed as area under receiver operating characteristic curve (AUROC) had a validity of 90.2% (95% CI AUROC = 0.831-0.972, P < 0.001) for the diagnosis of significant fibrosis (F ≥ 2). ARFI sonoelastography predicted even better F3 or F4 fibrosis (AUROC = 0.993, 95% CI = 0.979-1).

CONCLUSION: ARFI elastography had very good accuracy for the assessment of liver fibrosis and was superior to other noninvasive methods (APRI Index, FibroMax) for staging liver fibrosis.

Keywords: Elasticity imaging techniques, Hepatitis C, Liver biopsy, Liver fibrosis