Is ARFI elastography reliable for predicting fibrosis severity in chronic HCV hepatitis?
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Ioan Sporea1, Roxana Sirli, Simona Bota
1Ioan Sporea, Roxana Şirli, Simona Bota, Alina Popescu, Mirela Dănilă, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timişoara, 10 Iosif Bulbuca Bv., 300736 Timisoara, Romania.
Insights
Acoustic Radiation Force Impulse (ARFI) elastography accurately predicts fibrosis severity in chronic hepatitis C virus (HCV) patients. This non-invasive method shows strong correlation with liver biopsy results, offering a reliable diagnostic tool.
Area of Science:
- Hepatology
- Medical Imaging
- Diagnostic Technologies
Background:
- Chronic hepatitis C virus (HCV) infection leads to liver fibrosis.
- Accurate staging of liver fibrosis is crucial for patient management.
- Liver biopsy (LB) is invasive and has limitations for fibrosis assessment.
Purpose of the Study:
- To evaluate the reliability of Acoustic Radiation Force Impulse (ARFI) elastography for predicting liver fibrosis severity in HCV patients.
- To compare ARFI elastography measurements with liver biopsy (Metavir score).
Main Methods:
- A multicenter study involving 274 patients with HCV chronic hepatitis.
- Liver biopsy (LB) was performed and scored using the Metavir system.
- ARFI elastography measurements were obtained using a Siemens Acuson S2000™ ultrasound system, with median values expressed in meters/second (m/s).
Main Results:
- A strong positive correlation (Spearman r = 0.707, P < 0.0001) was observed between ARFI measurements and fibrosis stage.
- Specific ARFI cut-off values were determined for predicting different fibrosis stages (F≥1, F≥2, F≥3, F=4).
- High sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) values were achieved for predicting fibrosis severity.
Conclusions:
- ARFI elastography is a reliable, non-invasive method for assessing liver fibrosis severity in HCV patients.
- ARFI measurements provide accurate predictions comparable to liver biopsy.
- This technique offers a valuable tool for managing patients with chronic hepatitis C.
Aim:
To determine whether acoustic radiation force impulse (ARFI) elastography is a reliable method for predicting fibrosis severity in patients with chronic hepatitis C virus (HCV) hepatitis.
Methods:
We performed a multicenter study including 274 subjects with HCV chronic hepatitis in which we compared ARFI with liver biopsy (LB). In each patient we performed LB (evaluated according to the Metavir score) and ARFI measurements (using a Siemens Acuson S2000™ ultrasound system: 10 valid measurements were performed and median values were calculated and expressed in meters/second (m/s).
Results:
A direct, strong, correlation (Spearman r = 0.707) was found between ARFI measurements and fibrosis (P < 0.0001). For predicting the presence of fibrosis (F ≥ 1 Metavir), significant fibrosis (F ≥ 2), severe fibrosis (F ≥ 3) and cirrhosis (F = 4), the cut-off values of 1.19, 1.21, 1.58 and 1.82 m/s were determined, respectively, liver stiffness measurements had 73%, 84%, 84% and 91% Se respectively; 93%, 91%, 94%, 90% Sp, respectively; with AUROCs of 0.880, 0.893, 0.908 and 0.937, respectively.
Conclusion:
ARFI measurement is a reliable method for predicting the severity of fibrosis in HCV patients.
