Point shear wave Acoustic radiation force impulse elastography (pSW-ARFI) is A Noninvasive Tool to Diagnose Acute and Chronic Hepatic Graft-Versus-Host Disease in adult Patients Undergoing allogeneic HSCT.

Abstract

Purpose: The gold standard method of diagnosis of hepatic GVHD is liver biopsy. However, liver biopsy is an invasive procedure with risk of complications especially bleeding. ARFI imaging is a non-invasive, sensitive, and accurate tool for the assessment of liver fibrosis during routine conventional US evaluations.

Methods: The study was conducted prospectively on 30 adult patients undergoing allogeneic HSCT. pSW-ARFI elastography (stiffness and score) was performed for all patients: pre-transplant, within 3- and 6-months post-transplant. 

Results:  ARFI score and stiffness were higher in patients who developed acute hepatic GVHD in comparison to those who did not develop aGVHD (P-value= 0.028 and 0.03 respectively).Furthermore, the mean ARFI stiffness during the  1^st 3 months s post-transplant was directly correlated to the grade of acute hepatic GVHD (P-value= 0.012). Moreover; ARFI score and stiffness within 6 months post-transplant were higher in patients who developed chronic hepatic GVHD in comparison to those who did not develop (p-value= 0.020 and 0. 018 respectively). 

Conclusions: pSW-ARFI is a reliable non-invasive tool for the early diagnosis of acute and chronic hepatic GVHD especially if a liver biopsy is not feasible. It can also be used in the grading of acute hepatic GVHD.