Role of acoustic radiation force impulse elastography, aminotransferase to platelet ratio index and fibrotest for the assessment of significant fibrosis and cirrhosis in chronic liver disease

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dc.contributor.authorRijhwani, Anuragen_US
dc.contributor.authorMohanani, Laxmien_US
dc.contributor.authorChouhan, Ankit Ranjitsinhen_US
dc.contributor.authorKhatri, Nikunj M.en_US
dc.date.accessioned2020-11-18T10:02:08Z
dc.date.available2020-11-18T10:02:08Z
dc.date.issued2020-07
dc.description.abstractBackground: Accurate grading of hepatic fibrosis is important for the application of appropriate intervening strategy. Liver biopsy is the golden standard of fibrotic grading, however wide clinical application is hindered by its inherent drawbacks. Biomechanical-based ultrasonic elastography has received mass attention. However, several clinical studies found that the sole application of ultrasonic elastography may bring evident errors in diagnosing hepatic fibrosis. It is suggested that a combination of ultrasonic elastography and serum liver functions tests holds the potential to overcome those disadvantages. Aims and objectives was to study the diagnostic accuracy of ultrasonography elastography, APRI, fibrotest for significant fibrosis and cirrhosis in patients with chronic liver disease and established the correlation between ARFI elastography, APRI, Fibrotest in grading of liver fibrosisMethods: Sixty three patients with chronic liver disease were studied.  Liver stiffness was evaluated with ARFI elastography. Histologic staging of liver fibrosis served as the reference standard except a very few cirrhotic patients who were graded as cirrhotic on the basis of clinical examination. The required APRI, Fibrotest parameters and relevant clinical history was recorded.  Fibrosis stage was assessed according to the METAVIR classification.Results: ARFI, APRI, and Fibrotest demonstrated a significant correlation with the histological stage. According to ARFI and APRI for evaluating fibrotic stages more than F2, ARFI showed an enhanced diagnostic accuracy than APRI. The combined measurement of ARFI and APRI exhibited better accuracy than ARFI alone when evaluating ≥ F2 fibrotic stage that showed  significant concordance  i.e. 79.3% cases,  out of which 69.8% of total cases were correctly diagnosed on comparison with the gold standard. Fibrotest and ARFI elastography show significant concordance in grading of fibrosis i.e. 82.5%. Cases out of which 68.3% of total cases were correctly diagnosed on comparison with the gold standard.Conclusions: APRI, ARFI, and fibrotest are novel tools among non-invasive modalities to rule out significant fibrosis and cirrhosis in patients with chronic liver disease. ARFI with APRI and ARFI with fibrotest showed enhanced diagnostic accuracy than ARFI or APRI or fibrotest alone for significant liver fibrosis.en_US
dc.identifier.affiliationsConsultant Radiologist, DNB Radiodiagnosis, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, Indiaen_US
dc.identifier.affiliationsDepartment of Internal Medicine, Gandhi Medical College Bhopal, Madhya Pradesh, Indiaen_US
dc.identifier.affiliationsConsultant Radiologist, DMRD, DNB Radiodiagnosis, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, Indiaen_US
dc.identifier.citationRijhwani Anurag, Mohanani Laxmi, Chouhan Ankit Ranjitsinh, Khatri Nikunj M.. Role of acoustic radiation force impulse elastography, aminotransferase to platelet ratio index and fibrotest for the assessment of significant fibrosis and cirrhosis in chronic liver disease. International Journal of Research in Medical Sciences. 2020 Jul; 8(7): 2495-2501en_US
dc.identifier.issn2320-6071
dc.identifier.issn2320-6012
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/212449
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber7en_US
dc.relation.volume8en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-6012.ijrms20202885en_US
dc.subjectAcoustic radiation force impulseen_US
dc.subjectAspartate aminotransferase to platelet ratio indexen_US
dc.subjectFibrotesten_US
dc.subjectNon-invasive diagnosisen_US
dc.titleRole of acoustic radiation force impulse elastography, aminotransferase to platelet ratio index and fibrotest for the assessment of significant fibrosis and cirrhosis in chronic liver diseaseen_US
dc.typeJournal Articleen_US
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