Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse: comparison with Fibroscan®

Hirotoshi Ebinuma, Hidetsugu Saito, Mina Komuta, Keisuke Ojiro, Kanji Wakabayashi, Shingo Usui, Po sung Chu, Rumiko Umeda, Yuka Ishibashi, Tetsurou Takayama, Masahiro Kikuchi, Nobuhiro Nakamoto, Yoshiyuki Yamagishi, Takanori Kanai, Kiyoshi Ohkuma, Michiie Sakamoto, Toshifumi Hibi

Research output: Contribution to journalArticle

Abstract

Background: Accurate evaluation of liver fibrosis in patients with chronic liver damage is required to determine the appropriate treatment. Various approaches, including laboratory tests and transient elastography, have been used to evaluate liver fibrosis. Recently, transient elastography with acoustic radiation force impulse (ARFI) has been developed and applied with conventional ultrasonography. The aim of this study was to evaluate the clinical utility of transient elastography with ARFI and to compare the results with this method and those of the Fibroscan® procedure. Methods: One hundred and thirty-one patients with liver damage, who underwent liver biopsy at our department, were enrolled prospectively in this study. Elastography with ARFI (applied with ACUSON S2000®), and Fibroscan® was performed at the same time as liver biopsy. These measurements were compared with histological findings in liver biopsy specimens, and measurement accuracy was evaluated by receiver-operating characteristic analysis. Results: Elastography values with both procedures were significantly correlated with the stages of liver fibrosis and there was little difference in the results obtained using the 2 procedures. The accuracy of differential diagnosis between no fibrosis at F0 and more than F1 stage was insufficient with ARFI, but this procedure was sufficient for diagnosing advanced fibrosis. The accuracy of ARFI was almost equivalent to that of the Fibroscan® method. Moreover, both ARFI and Fibroscan® values increased in proportion to the severity of hepatic inflammation when fibrosis stage is low, but not in proportion to the severity of steatosis. Conclusions: Transient elastography with ARFI is simple, non-invasive and useful for diagnosing the stage of fibrosis in chronic liver disease. The utility of ARFI was almost equivalent to that of the Fibroscan® method.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalJournal of Gastroenterology
DOIs
Publication statusAccepted/In press - 2011

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Elasticity Imaging Techniques
Acoustics
Liver Cirrhosis
Radiation
Liver
Fibrosis
Biopsy
ROC Curve
Liver Diseases
Ultrasonography
Differential Diagnosis
Chronic Disease
Inflammation

Keywords

  • Acoustic radiation force impulse
  • Fibrosis
  • Liver stiffness
  • Non-invasive
  • Transient elastography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse : comparison with Fibroscan®. / Ebinuma, Hirotoshi; Saito, Hidetsugu; Komuta, Mina; Ojiro, Keisuke; Wakabayashi, Kanji; Usui, Shingo; Chu, Po sung; Umeda, Rumiko; Ishibashi, Yuka; Takayama, Tetsurou; Kikuchi, Masahiro; Nakamoto, Nobuhiro; Yamagishi, Yoshiyuki; Kanai, Takanori; Ohkuma, Kiyoshi; Sakamoto, Michiie; Hibi, Toshifumi.

In: Journal of Gastroenterology, 2011, p. 1-11.

Research output: Contribution to journalArticle

Ebinuma, H, Saito, H, Komuta, M, Ojiro, K, Wakabayashi, K, Usui, S, Chu, PS, Umeda, R, Ishibashi, Y, Takayama, T, Kikuchi, M, Nakamoto, N, Yamagishi, Y, Kanai, T, Ohkuma, K, Sakamoto, M & Hibi, T 2011, 'Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse: comparison with Fibroscan®', Journal of Gastroenterology, pp. 1-11. https://doi.org/10.1007/s00535-011-0437-3
Ebinuma, Hirotoshi ; Saito, Hidetsugu ; Komuta, Mina ; Ojiro, Keisuke ; Wakabayashi, Kanji ; Usui, Shingo ; Chu, Po sung ; Umeda, Rumiko ; Ishibashi, Yuka ; Takayama, Tetsurou ; Kikuchi, Masahiro ; Nakamoto, Nobuhiro ; Yamagishi, Yoshiyuki ; Kanai, Takanori ; Ohkuma, Kiyoshi ; Sakamoto, Michiie ; Hibi, Toshifumi. / Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse : comparison with Fibroscan®. In: Journal of Gastroenterology. 2011 ; pp. 1-11.
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abstract = "Background: Accurate evaluation of liver fibrosis in patients with chronic liver damage is required to determine the appropriate treatment. Various approaches, including laboratory tests and transient elastography, have been used to evaluate liver fibrosis. Recently, transient elastography with acoustic radiation force impulse (ARFI) has been developed and applied with conventional ultrasonography. The aim of this study was to evaluate the clinical utility of transient elastography with ARFI and to compare the results with this method and those of the Fibroscan{\circledR} procedure. Methods: One hundred and thirty-one patients with liver damage, who underwent liver biopsy at our department, were enrolled prospectively in this study. Elastography with ARFI (applied with ACUSON S2000{\circledR}), and Fibroscan{\circledR} was performed at the same time as liver biopsy. These measurements were compared with histological findings in liver biopsy specimens, and measurement accuracy was evaluated by receiver-operating characteristic analysis. Results: Elastography values with both procedures were significantly correlated with the stages of liver fibrosis and there was little difference in the results obtained using the 2 procedures. The accuracy of differential diagnosis between no fibrosis at F0 and more than F1 stage was insufficient with ARFI, but this procedure was sufficient for diagnosing advanced fibrosis. The accuracy of ARFI was almost equivalent to that of the Fibroscan{\circledR} method. Moreover, both ARFI and Fibroscan{\circledR} values increased in proportion to the severity of hepatic inflammation when fibrosis stage is low, but not in proportion to the severity of steatosis. Conclusions: Transient elastography with ARFI is simple, non-invasive and useful for diagnosing the stage of fibrosis in chronic liver disease. The utility of ARFI was almost equivalent to that of the Fibroscan{\circledR} method.",
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author = "Hirotoshi Ebinuma and Hidetsugu Saito and Mina Komuta and Keisuke Ojiro and Kanji Wakabayashi and Shingo Usui and Chu, {Po sung} and Rumiko Umeda and Yuka Ishibashi and Tetsurou Takayama and Masahiro Kikuchi and Nobuhiro Nakamoto and Yoshiyuki Yamagishi and Takanori Kanai and Kiyoshi Ohkuma and Michiie Sakamoto and Toshifumi Hibi",
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T1 - Evaluation of liver fibrosis by transient elastography using acoustic radiation force impulse

T2 - comparison with Fibroscan®

AU - Ebinuma, Hirotoshi

AU - Saito, Hidetsugu

AU - Komuta, Mina

AU - Ojiro, Keisuke

AU - Wakabayashi, Kanji

AU - Usui, Shingo

AU - Chu, Po sung

AU - Umeda, Rumiko

AU - Ishibashi, Yuka

AU - Takayama, Tetsurou

AU - Kikuchi, Masahiro

AU - Nakamoto, Nobuhiro

AU - Yamagishi, Yoshiyuki

AU - Kanai, Takanori

AU - Ohkuma, Kiyoshi

AU - Sakamoto, Michiie

AU - Hibi, Toshifumi

PY - 2011

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N2 - Background: Accurate evaluation of liver fibrosis in patients with chronic liver damage is required to determine the appropriate treatment. Various approaches, including laboratory tests and transient elastography, have been used to evaluate liver fibrosis. Recently, transient elastography with acoustic radiation force impulse (ARFI) has been developed and applied with conventional ultrasonography. The aim of this study was to evaluate the clinical utility of transient elastography with ARFI and to compare the results with this method and those of the Fibroscan® procedure. Methods: One hundred and thirty-one patients with liver damage, who underwent liver biopsy at our department, were enrolled prospectively in this study. Elastography with ARFI (applied with ACUSON S2000®), and Fibroscan® was performed at the same time as liver biopsy. These measurements were compared with histological findings in liver biopsy specimens, and measurement accuracy was evaluated by receiver-operating characteristic analysis. Results: Elastography values with both procedures were significantly correlated with the stages of liver fibrosis and there was little difference in the results obtained using the 2 procedures. The accuracy of differential diagnosis between no fibrosis at F0 and more than F1 stage was insufficient with ARFI, but this procedure was sufficient for diagnosing advanced fibrosis. The accuracy of ARFI was almost equivalent to that of the Fibroscan® method. Moreover, both ARFI and Fibroscan® values increased in proportion to the severity of hepatic inflammation when fibrosis stage is low, but not in proportion to the severity of steatosis. Conclusions: Transient elastography with ARFI is simple, non-invasive and useful for diagnosing the stage of fibrosis in chronic liver disease. The utility of ARFI was almost equivalent to that of the Fibroscan® method.

AB - Background: Accurate evaluation of liver fibrosis in patients with chronic liver damage is required to determine the appropriate treatment. Various approaches, including laboratory tests and transient elastography, have been used to evaluate liver fibrosis. Recently, transient elastography with acoustic radiation force impulse (ARFI) has been developed and applied with conventional ultrasonography. The aim of this study was to evaluate the clinical utility of transient elastography with ARFI and to compare the results with this method and those of the Fibroscan® procedure. Methods: One hundred and thirty-one patients with liver damage, who underwent liver biopsy at our department, were enrolled prospectively in this study. Elastography with ARFI (applied with ACUSON S2000®), and Fibroscan® was performed at the same time as liver biopsy. These measurements were compared with histological findings in liver biopsy specimens, and measurement accuracy was evaluated by receiver-operating characteristic analysis. Results: Elastography values with both procedures were significantly correlated with the stages of liver fibrosis and there was little difference in the results obtained using the 2 procedures. The accuracy of differential diagnosis between no fibrosis at F0 and more than F1 stage was insufficient with ARFI, but this procedure was sufficient for diagnosing advanced fibrosis. The accuracy of ARFI was almost equivalent to that of the Fibroscan® method. Moreover, both ARFI and Fibroscan® values increased in proportion to the severity of hepatic inflammation when fibrosis stage is low, but not in proportion to the severity of steatosis. Conclusions: Transient elastography with ARFI is simple, non-invasive and useful for diagnosing the stage of fibrosis in chronic liver disease. The utility of ARFI was almost equivalent to that of the Fibroscan® method.

KW - Acoustic radiation force impulse

KW - Fibrosis

KW - Liver stiffness

KW - Non-invasive

KW - Transient elastography

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