Acoustic Radiation Force Impulse (ARFI) in the Evaluation of Liver Fibrosis in Chronic Liver Disease

Abstract

Chronic liver disease (CLD) is common in clinical practice, and the estimation of liver fibrosis (FIB) is crucial for the treatment of these patients. Liver elastography is more widely used in the evaluation of hepatic steatosis and FIB. Acoustic radiation force impulse (ARFIs) are an imaging technique which is available on ultrasonography machines to indicate tissue stiffness of various organs as it correlates with tissue elasticity. Various etiologies can cause moderate-to-severe hepatic FIB which can lead to altered liver function with structural and biochemical abnormalities which eventually result in liver failure. Commercially available ultrasound machines with incorporated ability for shear-wave (SW) technology and available software systems can perform ARFI. Usually, curved array 3.5–4 MHz transducers are used for obtaining SW velocities. We aim to review the clinical applications of ARFI as a noninvasive method using SW velocity measurements to assess the severity of liver FIB in liver parenchymal diseases. In this article, we have discussed the efficacy of quantitative assessment to evaluate the severity of liver disease which has a direct impact on the management and outcome of CLD.