Steatosis Dose Not Affect Diagnostic Performance of Acoustic Radiation Force Impulse in Nonalcoholic Fatty Liver Disease

Kang YW, Baek YH, Lee JH, Roh YH, Kwon HJ, Moon SY, Son MK and Jeong JS

Published on: 2023-01-23

Abstract

Aim: This study aimed to compare the diagnostic performance of non-invasive tests in predicting advanced fibrosis in patients with nonalcoholic fatty liver (NAFLD) and examine whether the accuracy of each diagnostic test was maintained according to the severity of steatosis or obesity and increased NAFLD activity score (NAS).

Materials and Methods: We retrospectively enrolled 132 patients with NAFLD using ultrasonography. The anthropometric data of the patients were collected on the day of admission, and blood tests, acoustic radiation force impulse (ARFI) imaging, and biopsy were performed the following day. Non-invasive diagnostic tests were evaluated for each subgroup according to the degree of steatosis, obesity, and nonalcoholic steatohepatitis.

Results: Acoustic radiation force impulse (ARFI) showed the highest diagnostic value among the various non-invasive tests. The area under the receiver operating characteristic curve (AUROC) values of ARFI, Aspartate aminotransferase to Platelet Ratio Index (APRI), fibrosis-4 index (FIB-4), and NAFLD fibrosis score (NFS) in the morbidly obese subgroup were 0.808, 0.793, 0.742, and 0.672, respectively. In the group having severe steatosis or NAS, the AUROC values of ARFI, APRI, FIB-4, and NFS were 0.716, 0.629, 0.669, and 0.617, for severe steatosis and 0.801, 0.723, 0.756, and 0.693, respectively, for NAS. ARFI was the only statistically significant test in patients with severe steatosis.

Conclusion: The ARFI remained unaffected by various factors, retaining its diagnostic performance. Therefore, we suggest that ARFI imaging is a good diagnostic test for screening advanced fibrosis in patients with NAFLD.