The performance of acoustic radiation force impulse imaging in predicting liver fibrosis in chronic liver diseases

Sonography-based noninvasive liver fibrosis assessment is promising in the prediction of treatment efficacy and prognosis in chronic liver disease (CLD) patients. Acoustic radiation force impulse imaging (ARFI) is a newly-developed transient elastography (TE) method integrated into a conventional ultrasound machine. The study aimed to assess the performance of ARFI imaging in the diagnosis of liver fibrosis in Taiwanese CLD patients. We also aimed to search for the optimal cut-off values in different fibrosis stages. A total of 60 CLD patients (40 males; mean age, 51.8 ± 11 years) were consecutively included. They received standard ARFI measurement within 2 weeks at the time of liver biopsy. There were eight patients with Metavir fibrosis stage 0 (F0), 16 patients with F1, 20 patients with F2, eight patients with F3, and eight patients with F4, respectively. The mean values among patient with F0, F1, F2, F3, and F4 were 1.17 ± 0.13, 1.30 ± 0.17, 1.31 ± 0.24, 2.01 ± 0.45, and 2.69 ± 0.91, respectively (p < 0.001). The optimal cut-off ARFI value for significant fibrosis (F ≥ 2) was 1.53 with the accuracy of 0.733, while it was 1.66 for advanced fibrosis (F ≥ 3) with the accuracy of 0.957. Our study demonstrated that ARFI imaging is competent for fibrosis diagnosis, particularly in CLD patients with advanced fibrosis.