Acoustic radiation force impulse imaging for assessing liver fibrosis in alcoholic liver disease

Table 1 Clinical and biochemical characteristics of patients with alcoholic liver disease

Characteristic	Normal values	Patients included(n = 82)
Sex (male/female)	NA	69/13
Age (yr)	NA	43.8 ± 10
Body mass index (kg/m2)	NA	22.9 ± 4.3
AST (IU/L)	0-35	62.0 (44-98)
ALT (IU/L)	0-35	67.0 (40-105)
γ-glutamyl transpeptidase (IU/L)	5-36	316.0 (141-654)
γ-globulin (g/L)	7-15	8.7 (7.4-10.4)
Alkaline phosphatase (IU/L)	30-120	90.5 (66-121)
Prothrombin (%)	70-130	101.2 ± 12.4
Platelets (× 109/L)	180-390	191.5 ± 71.7
Iron (μmol/L)	18-22	16.2 ± 8.1
Ferritin (μg/L)	Male: 30-300	478.0 (310.5-787.5)
	Female: 20-150	404.0 (216.0-783.0)
Albumin (g/L)	40-60	39.0 ± 4.9

Kolmogorow Smirnow analysis was performed, followed by parametric or non-parametric tests. Mean ± SD or median (25^th-75^th interquartile ranges) was used respectively. AST: Aspartate transaminase; ALT: Alanine transaminase; IU: International unit.

Table 2 Number of patients and mean values of acoustic radiation force impulsepredicting for assessing liver stiffness according to the different fibrosis stages

Fibrosis stage	Number of patients	ARFI (m/s)
F0	13	1.25 ± 0.31
F1	35	1.40 ± 0.36
F2	17	1.86 ± 0.42
F3	4	1.83 ± 0.47
F4	13	2.25 ± 0.36
P value		< 0.0001

ARFI: Acoustic radiation force impulsepredicting.

Table 3 Diagnostic performance of acoustic radiation force impulse for the different liver fibrosis stages

Diagnostic parameters	F ≥ 2	F ≥ 3	F = 4
ARFI cut-off (m/s)	1.63	1.84	1.94
Sensitivity (%)	82.4 (0.70-0.95)	82.4 (0.64-1.00)	92.3 (0.78-1.00)
Specificity (%)	83.3 (0.73-0.94)	78.5 (0.69-0.89)	81.6 (0.72-0.90)
Area under curve (AUROC)	0.87	0.86	0.89
PPV (%)	77.8 (0.64-0.91)	50.0 (0.31-0.69)	48.0 (0.28-0.68)
NPV (%)	87.0 (0.77-0.97)	94.4 (0.88-1.00)	98.2 (0.95-1.00)

ARFI: Acoustic radiation force impulse; PPV: Positive predictive value; NPV: Negative predictive value.

Table 4 Univariate and multivariate ordinal regression analyses

Characteristic	Univariate analysis	Multivariate analysis
	OR (95%)	OR (95%)
	P value	R2 = 0.61;
		STPOA1: 0.76
ARFI	29.06 [8.59-98.33]	40.71 [9.94-166.7]
	P < 0.0001	P < 0.0001
Sex
Female	1
Male	2.43 [0.79-7.42]
	P = 0.12
Age
< 50 yr	1	1
≥ 50 yr	4.01 [1.55-10.39]	4.73 [1.43-15.66]
	P = 0.004	P = 0.01
Body mass index	1.07 [0.97-1.18]
	P = 0.19
AST	1.00 [0.992-1.01]
	P = 0.98
ALT	0.99 [0.98-0.999]
	P = 0.04
γ-glutamyl transpeptidase	1.00 [1.000-1.002]
	P = 0.05
γ-globulin
< 10	1	1
≥ 10	7.42 [2.34-23.56]	9.67 [2.19-42.63]
	P = 0.003	P = 0.004
Alkaline phosphatase	1.01 [1.001-1.012]
	P = 0.02
Prothrombin	0.002 [0.001-0.06]
	P = 0.001
Platelets	1.00 [0.99-1.01]
	P = 0.93
Iron	1.03 [0.97-1.08]
	P = 0.33
Ferritin	1.001 [1.000-1.002]
	P = 0.06
Albumin	0.90 [0.82-1.00]
	P = 0.05

¹Score test for the proportional odds assumption.