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Evaluation of Acoustic Radiation Force Impulse (ARFI) for Fibrosis Staging in Chronic Liver Diseases

ACTA MEDICA INDONESIANA · Vol. 49 No. 2 (2017)

ISSN
2338-2732, 0125-9326
Terbit
2017-08-08
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng

Abstrak

Background: acoustic radiation force impulse (ARFI) is a new proposed noninvasive method for liver fibrosis staging. Integrated with B-mode ultrasonography, ARFI can be used to assess liver tissue condition. However its diagnostic accuracy is still being continuously evaluated. Also, there is lack of data regarding the utilization of ARFI in our population. This study aimed to evaluate the diagnostic value of ARFI as an alternative noninvasive modality for fibrosis staging in chronic hepatitis B and hepatitis C patients in our population. Methods: we conducted cross-sectional comparison of ARFI imaging and transient elastography on patients who underwent liver biopsy at Cipto Mangunkusumo Hospital. Fibrosis staging using METAVIR scoring system presented as standard reference. A total of 43 patients underwent liver biopsy was evaluated by ARFI imaging and transient elastography. Cut-off values were determined using receiver-operating characteristic (ROC). Results: both liver stiffness determined by ARFI and transient elastography (TE) were moderately correlated with METAVIR score with value of 0.581 and 0.613, respectively (both P<0.01). Diagnostic accuracy of ARFI predicted significant fibrosis (F≥2) with area under receiver operating characteristic curve (AUROC) of 0.773 (95% CI 0.616-0.930) and even better for cirrhosis (F4 fibrosis), expressed as AUROC of 0.856 (95% CI 0.736–0.975). Transient elastography was better for significant fibrosis with AUROC of 0.761 (95% CI 0.601–0.920) and was best for prediction of cirrhosis, expressed as AUROC of 0.845 (95% CI 0.722–0.968). Conclusion: ARFI is provided with more convenient evaluation of liver tissue condition, and its diagnostic accuracy is not significantly different from TE for staging liver fibrosis.

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Andri Sanityoso SulaimanAfiliasi tidak diketahui18
Gita ApriliciaAfiliasi tidak diketahui10
Ikhwan RinaldiAfiliasi tidak diketahui8
Marcellus SimadibrataAfiliasi tidak diketahui5
Cosmas Rinaldi Adithya LesmanaAfiliasi tidak diketahui5
Rino A GaniAfiliasi tidak diketahui4
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Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Evaluation of Acoustic Radiation Force Impulse (ARFI)  for Fibrosis Staging in Chronic Liver Diseases</dc:title>
	<dc:creator>Gani, Rino Alvani</dc:creator>
	<dc:creator>Hasan, Irsan</dc:creator>
	<dc:creator>Sanityoso, Andri</dc:creator>
	<dc:creator>Lesmana, Cosmas Rinaldi A</dc:creator>
	<dc:creator>Kurniawan, Juferdy</dc:creator>
	<dc:creator>Jasirwan, Chyntia Olivia Maurine</dc:creator>
	<dc:creator>Kalista, Kemal Fariz</dc:creator>
	<dc:creator>Lutfie, Lutfie</dc:creator>
	<dc:subject xml:lang="en-US">acoustic radiation force impulse (ARFI)</dc:subject>
	<dc:subject xml:lang="en-US">fibrosis</dc:subject>
	<dc:subject xml:lang="en-US">transient elastography</dc:subject>
	<dc:subject xml:lang="en-US">liver biopsy</dc:subject>
	<dc:description xml:lang="en-US">Background: acoustic radiation force impulse (ARFI) is a new proposed noninvasive method for liver fibrosis staging. Integrated with B-mode ultrasonography, ARFI can be used to assess liver tissue condition. However its diagnostic accuracy is still being continuously evaluated. Also, there is lack of data regarding the utilization of ARFI in our population. This study aimed to evaluate the diagnostic value of ARFI as an alternative noninvasive modality for fibrosis staging in chronic hepatitis B and hepatitis C patients in our population. Methods: we conducted cross-sectional comparison of ARFI imaging and transient elastography on patients who underwent liver biopsy at Cipto Mangunkusumo Hospital. Fibrosis staging using METAVIR scoring system presented as standard reference. A total of 43 patients underwent liver biopsy was evaluated by ARFI imaging and transient elastography. Cut-off values were determined using receiver-operating characteristic (ROC). Results: both liver stiffness determined by ARFI and transient elastography (TE) were moderately correlated with METAVIR score with value of 0.581 and 0.613, respectively (both P&amp;lt;0.01). Diagnostic accuracy of ARFI predicted significant fibrosis (F≥2) with area under receiver operating characteristic curve (AUROC) of 0.773 (95% CI 0.616-0.930) and even better for cirrhosis (F4 fibrosis), expressed as AUROC of 0.856 (95% CI 0.736–0.975). Transient elastography was better for significant fibrosis with AUROC of 0.761 (95% CI 0.601–0.920) and was best for prediction of cirrhosis, expressed as AUROC of 0.845 (95% CI 0.722–0.968). Conclusion: ARFI is provided with more convenient evaluation of liver tissue condition, and its diagnostic accuracy is not significantly different from TE for staging liver fibrosis.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2017-08-08</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/354</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 49 No. 2 (2017): Acta Medica Indonesiana; 128</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/354/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2017 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>