| Summary: | Acoustic Radiation Force Imaging (ARFI) is an emerging non-invasive procedure that is a potential alternative to liver biopsy. One significant advantage of ARFI imaging is that it is integrated into a conventional ultrasonographic system. This also allows for a sonographic evaluation of the liver to be performed simultaneously with ARFI; this provides patients an ideal 'one-stop shop' for noninvasive liver evaluation, even in patients with a significant amount of ascites. ARFI is a technology designed to measure shear wavefront at multiple locations to calculate tissue stiffness. The wave velocity determines tissue stiffness through a simple method: the stiffer the tissue, the greater velocity. The purpose of this Rapid Response report is to review the clinical effectiveness, diagnostic accuracy, cost-effectiveness, and evidence-based guidelines regarding the use of ARFI for detecting and grading liver fibrosis in patients with hepatitis C. This report represents an update to a previous 2012 report that reviewed the clinical and cost-effectiveness evidence of diagnosis and monitoring of liver fibrosis among patients with hepatitis C; that report found moderate to high accuracy for FibroTest, transient elastography (known as FibroScan), and aminotransferase-to-platelet ratio index (APRI) with generally higher accuracy for cirrhosis compared with earlier fibrosis stages
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