Obesity & Nutrition

Biography

Biography: Ma Marylaine Dujunco

Abstract

Background & Aim: Acoustic Radiation Force Impulse (ARFI) imaging is a method to evaluate tissue stiffness. This study aims to evaluate the use of ARFI to non-invasively determine if a liver mass is benign or malignant.

Methodology: This is a two-year cross-sectional study of patients’ diagnosed liver tumors those underwent liver elastography using ARFI at St. Luke’s Medical Center. Liver masses were grouped to either benign or malignant according to their etiology and the mean ARFI value per group was computed. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic accuracy of the ARFI measurement. The optimal cut-off value was chosen to maximize the sensitivity and specificity. A p value <0.05 was considered statistically significant.

Results: Among 90 included patients in the study, 23.3% of the patients had history of other malignancy and 35.5% had cirrhosis. 81.1% of the patients had malignant liver masses. Average ARFI value of malignant masses was 2.24 m/s while that of benign is 1.88 m/s (p=0.113). Based on the ROC curve, a cut off ARFI value of 1.965 m/s has the highest sensitivity and specificity to distinguish malignant from benign liver masses at 65.8% and 58.8%, respectively. Using a cut off ARFI value of 1.02 m/s, the sensitivity and specificity of diagnosing a liver mass to be malignant are 90.4% and 23.5%, respectively. Calculated positive likelihood ratio is 1.18 and negative likelihood ratio of 0.41.

Conclusion: ARFI imaging is a promising method to characterize a liver mass as benign or malignant. It can accurately and objectively assess the stiffness of the liver mass in a non-invasive way. Any liver mass with an ARFI value of ≤1.02 m/s is benign (sensitivity 90.4%, specificity 23.5%). Liver masses with ARFI value of >1.02 m/s is likely malignant hence further investigation is warranted.