Aim:to analyze the performance of ARFI and TE for diagnosing different fibrosis stages, using cut-offs values published by meta-analyses.
Methods:We analyzed 134 patients with chronic hepatitis C evaluated by ARFI, TE and liver biopsy (LB). For each method, ten liver stiffness (LS) measurements were performed in each patient and a median value was calculated. Reliable measurements for both ARFI and TE were defined as: median value of 10 LS measurements with a success rate≥60% and an interquartile range interval<30%. For predicting different fibrosis stages we used ARFI and TE cut-offs from the most recently published meta-analyses (1, 2).
Results:Reliable LS measurements with both elastographic methods were obtained in 109/134 (81.3%) of patients.
From the patients with LS values ≥1.35m/s(ARFI) and ≥7.6 kPa(TE), 96% and 93.8%, respectively had at least F2 at LB, while from the patients with LS values<1.35m/s (ARFI) and <7.6 kPa(TE), 75.8% and 77.9%,respectively had at least F2 at LB. Only 25% of patients with ARFI values<1.35m/s and F≥2 had TE values≥7.6kPa, and respectively only 28.2% of cases with TE values< 7.6kPa and ARFI values≥1.35m/s.
From the patients with LS values≥1.61m/s(ARFI) and ≥10.9kPa(TE),74.2% and 80%, respectively had at least F3 at LB, while from the patients with LS values<1.61m/s(ARFI) and<10.9 kPa(TE),23.2% and 27.7%, respectively had at least F3 at LB.
From the patients with LS values≥1.87m/s(ARFI) and ≥15.3kPa(TE),37.5% and 90%, respectively had cirrhosis at LB, while from the patients with LS values<1.87m/s (ARFI) and<15.3 kPa(TE), only 3.5% and 3.1%, respectively had F4 at LB.
Conclusions:Both elastographic techniques had very good performance for predicting F≥2, when LS values are above the meta-analysis cut-offs, but around 75% of cases with LS under the cut-offs had also F≥2.Both elastographic techniques had very good value for excluding liver cirrhosis.
References:
1.Tsochatzis et al.J Hepatol. 2011;54:650-6
2.Nierhoff et al. Eur Radiol 2013;23:4040-53
