Acoustic Radial Force Impulse as an effective tool for a prompt and reliable diagnosis of hepatocellular carcinoma - preliminary data

ARFI (Acoustic Radiation Force Impulse) is a novel method based on the use ofshear acoustic waves remotely induced by the radiation force of a focusedultrasonic beam. Recently, ARFI has been investigated as a non-invasive methodfor the assessment of liver fibrosis. The reproducibility of ARFI technology was proved in determining liver fibrosis: in detail, for cirrhosis Fibroscan had its best cut-off at >/= 11 kPa (AUROC of 0.80) whereas ARFI >/= 2.0 m/s (AUROC of0.89). By pair-wise comparison of AUROC, ARFI was significantly more accuratethan TE for a diagnosis of significant and severe fibrosis. Due to the low amountof collagen deposition within hepatocellular carcinoma (HCC) nodules in a contextof "hard" cirrhotic parenchyma, ARFI propose itself also as a novel, specificmethod for an early identification of primitive neoplastic nodules during thefollow up of cirrhotic patients. The diagnostic accuracy can be demonstratedeither versus the surrounding liver tissue or versus dysplastic or metastaticnodules. Further studies are required to confirm ARFI as a useful tool for HCCfollow-up.