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Acoustic Radiation Force Impulse Imaging for Diagnosis and Monitoring of Liver Fibrosis in Patients with Hepatitis C: A Review of Diagnostic Accuracy, Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Last updated: April 18, 2016
Project Number: RC0771-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of acoustic radiation force impulse imaging compared with liver biopsy for detecting and grading liver fibrosis in patients with hepatitis C?
  2. What is the diagnostic accuracy of acoustic radiation force impulse imaging compared with liver biopsy for detecting and grading liver fibrosis in patients with hepatitis C?
  3. What is the cost-effectiveness of acoustic radiation force impulse imaging compared with liver biopsy for detecting and grading liver fibrosis in patients with hepatitis C?
  4. What are the evidence-based guidelines regarding use of acoustic radiation force impulse imaging for detecting and grading liver fibrosis in patients with hepatitis C?

Key Message

Seventeen studies were identified regarding the diagnostic accuracy of acoustic radiation force impulse imaging compared with liver biopsy for detecting and grading liver fibrosis in patients with hepatitis C. The studies identified in this report suggest that acoustic radiation force impulse imaging (ARFI) is a comparable method to liver biopsy to evaluate liver fibrosis and cirrhosis in patients with hepatitis C. One study was identified on the cost-effectiveness of ARFI for detecting and grading liver fibrosis in patients with hepatitis C, where liver biopsy and ARFI were found to be dominated by less costly and more effective options for chronic hepatitis C patients. However, the economic model did not include costs for more recent hepatitis C treatment options and may not reflect current practice. No literature on guidelines and clinical effectiveness were identified.