Value of Acoustic Radiation Force Impulse Imaging Elastography for Non-invasive Evaluation of Patients with Nonalcoholic Fatty Liver Disease

Braticevici, Carmen Fierbinţeanu; Sporea, Ioan; Panaitescu, Eugenia; Tribus, Laura

doi:10.1016/j.ultrasmedbio.2013.04.019

Cited by 86 publications

(40 citation statements)

References 39 publications

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“…Significant correlation between ARFI values and the degree of fibrosis has been shown [108, 109]. More recently, ARFI has been investigated as a discriminating method between NASH and simple steatosis [110, 111]. Significantly higher ARFI velocities in NASH, and areas under the ROC curves of 0.87–0.9 for the differentiation between NASH and simple steatosis were found.…”

Section: Ultrasound Modalitiesmentioning

confidence: 99%

Ultrasound in chronic liver disease

2014

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BackgroundWith the high prevalence of diffuse liver disease there is a strong clinical need for noninvasive detection and grading of fibrosis and steatosis as well as detection of complications.MethodsB-mode ultrasound supplemented by portal system Doppler and contrast-enhanced ultrasound are the principal techniques in the assessment of liver parenchyma and portal venous hypertension and in hepatocellular carcinoma surveillance.ResultsFibrosis can be detected and staged with reasonable accuracy using Transient Elastography and Acoustic Radiation Force Imaging. Newer elastography techniques are emerging that are undergoing validation and may further improve accuracy. Ultrasound grading of hepatic steatosis currently is predominantly qualitative.ConclusionA summary of methods including B-mode, Doppler, contrast-enhanced ultrasound and various elastography techniques, and their current performance in assessing the liver, is provided.Teaching Points• Diffuse liver disease is becoming more prevalent and there is a strong clinical need for noninvasive detection.• Portal hypertension can be best diagnosed by demonstrating portosystemic collateral venous flow.• B-mode US is the principal US technique supplemented by portal system Doppler.• B-mode US is relied upon in HCC surveillance, and CEUS is useful in the evaluation of possible HCC.• Fibrosis can be detected and staged with reasonable accuracy using TE and ARFI.• US detection of steatosis is currently reasonably accurate but grading of severity is of limited accuracy.

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Section: Ultrasound Modalitiesmentioning

confidence: 99%

Ultrasound in chronic liver disease

2014

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“…Similarly, ARFI-based SWE has shown an area under the ROC curve of 0.944 [76] in differentiating ‡F2 fibrosis and other studies have shown AUROC values of 0.90-0.97 in differentiating ‡F3 fibrosis in patients with NAFLD [67,84]. Furthermore, a study by GuzmanAroca et al [74] showed that NAFLD could be differentiated from patients with NASH or fibrosis using ARFI elastography with an accuracy of 0.899 with a sensitivity of 85% and specificity of 83.3% at an optimal cut-off value of 1.3 m/sec.…”

Section: Non-alcoholic Fatty Liver Disease (Nafld)mentioning

confidence: 99%

“…It is, however, well established that hepatic inflammation increases estimated liver stiffness, potentially confounding fibrosis staging [49,69,[72][73][74][75][76][77]. As a result, liver stiffness in NASH may be increased as a result of fibrosis and/or inflammation (Fig.…”

Section: Non-alcoholic Fatty Liver Disease (Nafld)mentioning

confidence: 99%

Ultrasound elastography: liver

2015

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Ultrasound elastography, also termed sonoelastography, is being used increasingly in clinical practice to aid the diagnosis and management of diffuse liver disease. Elastography has been shown to be capable of differentiating advanced and early-stage liver fibrosis, and consequently a major application in clinical liver care includes progression to cirrhosis risk stratification through (1) assessment of liver fibrosis stage in HCV and HBV patients, (2) distinguishing non-alcoholic steatohepatitis from simple steatosis in non-alcoholic fatty liver disease patients, and (3) prognostic evaluation of liver disease is autoimmune liver disease. In addition, elastographic characterization of focal liver lesions and evaluation of clinically significant portal hypertension have the potential to be clinically useful and are areas of active clinical research.

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“…Elastometry values increase after food intake, and measurements should be performed in the fasting state (or at least 3 h after the last meal) [106,107] . Although in a limited number of studies, the method has been evaluated in a variety of liver conditions, such as metabolic liver diseases [108][109][110][111][112] , autoimmune liver diseases [113] , hepatic tumors [114,115] , and chronic hepatitis B [116,117] . However, like TE, ARFI has been most studied in patients with chronic HCV infection [118][119][120][121][122][123][124][125][126][127][128] .…”

Section: Imaging Techniquesmentioning

confidence: 99%

Non-invasive diagnosis of liver fibrosis in chronic hepatitis C

Schiavon

Narciso-Schiavon

Carvalho-Filho

2014

WJG

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Assessment of liver fibrosis in chronic hepatitis C virus (HCV) infection is considered a relevant part of patient care and key for decision making. Although liver biopsy has been considered the gold standard for staging liver fibrosis, it is an invasive technique and subject to sampling errors and significant intra- and inter-observer variability. Over the last decade, several noninvasive markers were proposed for liver fibrosis diagnosis in chronic HCV infection, with variable performance. Besides the clear advantage of being noninvasive, a more objective interpretation of test results may overcome the mentioned intra- and inter-observer variability of liver biopsy. In addition, these tests can theoretically offer a more accurate view of fibrogenic events occurring in the entire liver with the advantage of providing frequent fibrosis evaluation without additional risk. However, in general, these tests show low accuracy in discriminating between intermediate stages of fibrosis and may be influenced by several hepatic and extra-hepatic conditions. These methods are either serum markers (usually combined in a mathematical model) or imaging modalities that can be used separately or combined in algorithms to improve accuracy. In this review we will discuss the different noninvasive methods that are currently available for the evaluation of liver fibrosis in chronic hepatitis C, their advantages, limitations and application in clinical practice.

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Value of Acoustic Radiation Force Impulse Imaging Elastography for Non-invasive Evaluation of Patients with Nonalcoholic Fatty Liver Disease

Cited by 86 publications

References 39 publications

Ultrasound in chronic liver disease

Ultrasound in chronic liver disease

Ultrasound elastography: liver

Non-invasive diagnosis of liver fibrosis in chronic hepatitis C

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