The Value of Acoustic Radiation Force Impulse Elastography Fibrosis Evaluation in Patients with Chronic HCV Hepatitis: A Multicentric International Study

To find if ARFI is a reliable method for predicting the severity of fibrosis in patients with chronic HCV hepatitis. Our study included 430 subjects (213 women and 217 men), mean age 52.2 ± 12.1 years, with HCV chronic hepatitis in which we compared ARFI with the liver biopsy (LB). In each patient we performed LB in the same session (evaluated according to the Metavir score) and ARFI measurements (10 valid measurements were performed and median values were calculated, expressed in meters/second - m/s). From the 430 patients, valid ARFI measurements were obtained in 427 (99.3%) of the cases. On LB, from the 430 patients, 37 (8.6%) subjects had F0, 79 (18.3%) had F1, 110 (25.6%) had F2, 90 (20.9%) had F3 and 114 (26.5%) had F4. A direct, strong correlation (r = 0.715) was found between ARFI measurements and fibrosis (p < 0.0001). The predictive value of ARFI for various stages of fibrosis were: -F ≥ 1: cut-off >1.19 m/s, AUROC = 0.814; 66.6% Se, 89.1% Sp, 98.4% PPV, 20.2% NPV, 68.6% accuracy; F ≥ 2: cut-off >1.21 m/s, AUROC = 0.838; 76.5% Se, 85.3% Sp, 93.3% PPV, 57.5% NPV, 78.9% accuracy; F ≥ 3: cut-off >1.49 m/s, AUROC = 0.870; 76.8% Se, 89.2% Sp, 86.6% PPV, 80.9% NPV, 83.3% accuracy; F = 4: cut-off >1.74 m/s, AUROC = 0.861; 80.7% Se, 84.3% Sp, 65.2% PPV, 92.3% NPV, 83.3% accuracy. ARFI Elastography is a reliable method for predicting the severity of fibrosis in HCV patients.