Impact of Acoustic Radiation Force Impulse Imaging in Clinical Practice of Patients after Orthotopic Liver Transplantation

Source of support: Departmental sources Background: Acoustic radiation force impulse (ARFI) elastography is a reliable diagnostic device for quantitative non-inva-sive assessment of liver fibrosis in patients with chronic liver disease. The aim of our prospective study was to evaluate the impact of ARFI in patients after orthotopic liver transplantation (OLT). Therefore, we compared ARFI shear wave velocities with clinical features, non-invasive markers, and the histology of patients following OLT. Material/Methods: Post-transplant patients underwent a clinical examination and blood samples were taken. B-mode and Doppler ultrasound (US) of the portal vein and the hepatic artery were performed. Subsequently, a minimum of 10 val-id ARFI values were measured in the left and right liver lobe. Liver biopsy was performed if indicated. Results: Between May 2012 and May 2014, 58 Patients after OLT were included in the prospective study. Laboratory markers and aspartate aminotransferase-to-platelet ratio index (APRI) correlated with ARFI values (r=0.44, p<0.001). The histological (n=22) fibrosis score (Ludwig) was significantly correlated with the ARFI of the biop-sy site (r=0.55, p=0.008). The mean shear-wave velocities were significantly increased in advanced fibrosis (F£2 1.57±0.57 m/s; F3 2.85±0.66 m/s; p<0.001), obstructive cholestasis and active viral hepatitis. The area under the receiver operating characteristic (AUROC) curves for the accuracy of ARFI were 74 % (F1), 73 % (F2), 93