Abstracts 21 st Annual Conference of Indian National Association for the Study of Liver (INASL), March 22–24, 2013 Hyderabad International Convention Centre, Hyderabad, India LIVER FIBROSIS REFERRAL PATTERN AND INDICATIONS USED FOR EVALUATION OF LIVER FIBROSIS Ravi Shankar Bagepally, G. R. Srinivas Rao, S. Jithender Reddy, A. Vidya Sagar, B. Ramesh Kumar, Shravan Kumar, Kiran Peddi, S. Rajesh, D. V. Srinivas, Sethu Babu Liver Fibrosis Research Group Yashoda Hospitals, Secunderabad, Andhra Pradesh, India Background and Aim: Liver stiffness measurement (LSM) using fibroscan (echosens)is a newly introduced noninva- sive tool that generates an elastic wave using a vibrator ap- plied to the thoracic wall on the right lobe of Liver.LSM helps physicians to diagnose disease and monitor progres- sion. Not much experience is available with the usage of echosens machine.We evaluated the basic reasons for refer- ral to Fibroscan in Hyderabad. Methods: Period of evaluation was 01.06.2012 to 31.12.2012. A total of 369 patients were evaluated. The cause for referral was determined after examining the pre- scription and confirming this with appropriate question- ing. LSM was determined using the ultrasonic vibrator applied to the right intercostal surface; CAP and fibroscore values were obtained after 15 successive estimations and a median value was obtained. Results: A Total of 369 subjects’ underwent the procedure; 75% were males; age group ranged from 11 to 85 years. Following was the breakup of referral indications: Conclusion: Common causes for evaluating liver fibrosis are fatty liver, chronic viral infection (B & C) and Cirrhosis. Rare reasons for evaluation are splenomegaly and drug in- duced fibrosis. Corresponding author. Ravi Shankar Bagepally. E-mail: b_ravishankar@yahoo.com ACOUSTIC RADIATION FORCE IMPULSE IMAGING AS NONINVASIVE MARKER OF HEPATIC FIBROSIS Daksh Khurana Varadaraj Gokak, M. A. Mateen, Anuradha Sekaran, Rajesh Gupta, P. N. Rao, Manu Tandan, Nageshwar Reddy Asian Institute of Gastroenterology, Hyderabad, India Background: Acoustic Radiation Force impulse Imaging (ARFI) is a novel non-invasive technique studying the lo- calized mechanical properties of tissue by utilizing short, high intensity acoustic pulses (shear wave pulses) to assess the mechanical response(tissue displacement), providing a measure of tissue elasticity. Aims: To investigate the feasibility of ARFI imaging as a noninvasive method for assessing liver fibrosis compared to liver biopsy scores in patients with suspected chronic liver disease. Method: A prospective comparison study of ARFI elas- tography (Virtual Touch imaging, ACUSON S2000 ultra- sound unit, Siemens) in a consecutive series of patients who underwent liver biopsy for assessment of liver stiff- ness was measured in meters per second. Mean ARFI ve- locities were compared with Modified Ishak scores and Brunt score for fibrosis in liver biopsy findings. Results: Study included 40 patients of suspected chronic liver disease who underwent liver biopsy and ARFI Elastog- raphy from the same segment of liver between the age group of 38.7 Æ 14.4 years with predominant male gender (80%) over a period of 1 year. Cryptogenic cause for chronic hepatitis (32.5%) was the leading cause followed by NASH (22.5%) and then contributed equally by viral etiology of HCV and HBV (20%) each. The median ARFI value is 1.55mt/sec and there is an increasing trend of ARFI values as Childs score increases. ARFI proved to be a better predic- tor of advanced fibrosis (F3 or F4). The spearman rho Fatty liver (n=189), Mean CAP value 282, Mean Fibroscore 8.2 kPa HBV infection (n=46), Mean CAP value 241, Mean Fibroscore 12.4 kPa Cirrhosis liver (n=69), Mean CAP value 212, Mean Fibroscore 34.0 kPa Alcoholic liver Disease (n=27), Mean CAP value 255, Mean Fibroscore 37.7 kPa HCV infection (n=12), Mean CAP value 222, Mean Fibroscore 32.0 kPa Hepatomegaly (n=13), Mean CAP value 253, Mean Fibroscore 12.9 kPa Splenomegaly (n=06), Mean CAP value 208, Mean Fibroscore 7.5 kPa Others (n=07), Mean CAP value 251, Mean Fibroscore 8.0 kPa © 2013, INASL Journal of Clinical and Experimental Hepatology | March 2013 | Vol. 3 | No. 1S | S75–S77 Liver Fibrosis JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY