Prospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2016; 22(20): 4926-4935
Published online May 28, 2016. doi: 10.3748/wjg.v22.i20.4926
Acoustic radiation force impulse imaging for assessing liver fibrosis in alcoholic liver disease
Anita Kiani, Vanessa Brun, Fabrice Lainé, Bruno Turlin, Jeff Morcet, Sophie Michalak, Antonia Le Gruyer, Ludivine Legros, Edouard Bardou-Jacquet, Yves Gandon, Romain Moirand
Anita Kiani, Vanessa Brun, Yves Gandon, Department of Abdominal Imaging, Rennes University Hospital, 35033 Rennes, France
Fabrice Lainé, Jeff Morcet, Clinical Inverstigation Center, CIC INSERM 1414, Rennes University Hospital, 35033 Rennes, France
Fabrice Lainé, Antonia Le Gruyer, Ludivine Legros, Edouard Bardou-Jacquet, Romain Moirand, Department of Hepatology, Rennes University Hospital, 35033 Rennes, France
Bruno Turlin, Department of Pathology, Rennes University Hospital Rennes, 35033 Rennes, France
Sophie Michalak, Department of Pathology, Angers University Hospital, 49100 Angers, France
Romain Moirand, Department of Addictology, Rennes University Hospital, 35033 Rennes, France
Romain Moirand, Department of Research INSERM UMR 991, Rennes 1 Medicine University, 35000 Rennes, France
Author contributions: Kiani A, Lainé F and Moirand R designed the research; Kiani A, Brun V, Lainé F, Turlin B, Michalak S, Le Gruyer A, Legros L, Bardou-Jacquet E and Moirand R performed the research; Kiani A, Brun V, Lainé F, Morcet J, Gandon Y and Moirand R analyzed the data; Morcet J contributed to statistical analysis; Kiani A, Brun V, Lainé F, Morcet J, Bardou-Jacquet E nd Moirand R wrote the paper.
Institutional review board statement: The local ethics committee approved this study.
Clinical trial registration statement: This study is registered at https://clinicaltrials.gov/ct2/show/NCT01789008?term=NCT01789008&rank=1. The registration identification number is NCT01789008.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Anita Kiani, MD, Department of Abdominal Imaging, Rennes University Hospital, CHU Rennes, 2 rue H. Le Guilloux, 35033 Rennes, France. anita.kiani@chu-rennes.fr
Telephone: +33-2-99284309 Fax: +33-2-99284364
Received: February 10, 2016
Peer-review started: February 10, 2016
First decision: March 8, 2016
Revised: March 26, 2016
Accepted: April 7, 2016
Article in press: April 7, 2016
Published online: May 28, 2016
Processing time: 99 Days and 14.1 Hours
Abstract

AIM: To evaluate the performance of elastography by ultrasound with acoustic radiation force impulse (ARFI) in determining fibrosis stage in patients with alcoholic liver disease (ALD) undergoing alcoholic detoxification in relation to biopsy.

METHODS: Eighty-three patients with ALD undergoing detoxification were prospectively enrolled. Each patient underwent ARFI imaging and a liver biopsy on the same day. Fibrosis was staged according to the METAVIR scoring system. The median of 10 valid ARFI measurements was calculated for each patient.

RESULTS: Sixty-nine males and thirteen females (one patient excluded due to insufficient biopsy size) were assessed with a mean alcohol consumption of 132.4 ± 128.8 standard drinks per week and mean cumulative year duration of 17.6 ± 9.5 years. Sensitivity and specificity were respectively 82.4% (0.70-0.95) and 83.3% (0.73-0.94) (AUROC = 0.87) for F ≥ 2 with a cut-off value of 1.63m/s; 82.4% (0.64-1.00) and 78.5% (0.69-0.89) (AUROC = 0.86) for F ≥ 3 with a cut-off value of 1.84m/s; and 92.3% (0.78-1.00] and 81.6% (0.72-0.90) (AUROC = 0.89) for F = 4 with a cut-off value of 1.94 m/s.

CONCLUSION: ARFI is an accurate, non-invasive and easy method for assessing liver fibrosis in patients with ALD undergoing alcoholic detoxification.

Keywords: Alcoholic liver disease; Elastography; Non-invasive; Acoustic radiation force impulse; Fibrosis

Core tip: The aim of this study was to evaluate the performance of elastography by ultrasound with acoustic radiation force impulse (ARFI) in determining fibrosis stage in patients with alcoholic liver disease (ALD) undergoing alcoholic detoxification. Compared to biopsy, ARFI is an accurate, non-invasive and easy method for assessing liver fibrosis in patients with ALD undergoing alcoholic detoxification, with a good sensitivity and specificity.