Establishment of risk assessment for liver resection by liver stiffness measurement with acoustic radio force impulse (ARFI)

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We aimed to assess the usefulness of liver stiffness measurement based on Acoustic Radiation Force Impulse (ARFI) for the prediction of posthepatectomy liver failure (PHLF) by prospectively analyzing clinical data of 200 patients who underwent hepatic resection. Univariate analysis revealed that liver stiffness value measured by ARFI was one of the most efficient markers in predicting PHLF as well as an excellent indicator of the grade of pathological liver fibrosis. To improve the predictive accuracy, we further performed multivariate analysis and established a novel formula that quantitatively estimates the risk of PHLF by combination of 4 significant factors: liver stiffness, platelet count, total bilirubin, and remnant liver volume rate. The validity of the formula was verified, suggesting it could be applied to clinical use in the future.