EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Short Version)

Abstract

We present here the first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography with a focus on the assessment of diffuse liver disease. The short version provides clinical information about the practical use of elastography equipment and interpretation of results in the assessment of diffuse liver disease and analyzes the main findings based on published studies, stressing the evidence from meta-analyses. The role of elastography in different etiologies of liver disease and in several clinical scenarios is also discussed. All of the recommendations are judged with regard to their evidence-based strength according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. This updated document is intended to act as a reference and to provide a practical guide for both beginners and advanced clinical users.

Zusammenfassung

Dies ist die erste Überarbeitung der 2013 publizierten EFSUMB-Leitlinien zur klinischen Anwendung der Elastografie und konzentriert sich auf die diffusen Lebererkrankungen. Der klinische Teil dieser Leitlinien erläutert die praktische Anwendung der Elastografie bei der Beurteilung diffuser Lebererkrankungen unter Berücksichtigung der Geräteausstattung und Interpretation der Ergebnisse. Die aktuelle Literatur wurde analysiert unter besonderer Beachtung von Metaanalysen. Die klinische Anwendung der Elastografie wird unter Reflexion unterschiedlicher klinischer Szenarien und der unterschiedlichen Ätiologien diffuser Lebererkrankungen erläutert. Alle Empfehlungen erfolgten gemäß der Evidenz basierten Methodik der Oxford-Klassifikation. Das hier vorgestellte Update soll dem Anfänger und fortgeschrittenen Nutzer eine praktische Hilfe darstellen.

Key words

guidelines - liver - fibrosis - chronic liver disease - hepatitis - chronic viral hepatitis - shear wave elastography - strain elastography - alcoholic hepatitis - NAFLD

• References

• 1 EFSUMB. Education and Professional Standards Committee (EPSC) Minimum Training recommendations for the practice of medical ultrasound. Ultraschall in Med 2006; 27: 79-105
• 2 Fabrellas N. Alemany M. Urquizu M. et al. Using transient elastography to detect chronic liver diseases in a primary care nurse consultancy. Nurs Res 2013; 62: 450-454
• 3 Sporea I. Sirli RL. Deleanu A. et al. Acoustic radiation force impulse elastography as compared to transient elastography and liver biopsy in patients with chronic hepatopathies. Ultraschall in Med 2011; 32: S46-S52
• 4 Barr RG. Ferraioli G. Palmeri ML. et al. Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement. Radiology 2015; 276: 845-861
• 5 Wang CZ. Zheng J. Huang ZP. et al. Influence of measurement depth on the stiffness assessment of healthy liver with real-time shear wave elastography. Ultrasound Med Biol 2014; 40: 461-469
• 6 Procopet B. Berzigotti A. Abraldes JG. et al. Real-time shear-wave elastography: applicability, reliability and accuracy for clinically significant portal hypertension. J Hepatol 2015; 62: 1068-1075
• 7 Bamber J. Cosgrove D. Dietrich CF. et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall in Med 2013; 34: 169-184
• 8 Ferraioli G. Filice C. Castera L. et al. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 3: liver. Ultrasound Med Biol 2015; 41: 1161-1179
• 9 Liao LY. Kuo KL. Chiang HS. et al. Acoustic radiation force impulse elastography of the liver in healthy patients: test location, reference range and influence of gender and body mass index. Ultrasound Med Biol 2015; 41: 698-704
• 10 Goertz RS. Egger C. Neurath MF. et al. Impact of food intake, ultrasound transducer, breathing maneuvers and body position on acoustic radiation force impulse (ARFI) elastometry of the liver. Ultraschall in Med 2012; 33: 380-385
• 11 Goertz RS. Zopf Y. Jugl V. et al. Measurement of liver elasticity with acoustic radiation force impulse (ARFI) technology: an alternative noninvasive method for staging liver fibrosis in viral hepatitis. Ultraschall in Med 2010; 31: 151-155
• 12 Mederacke I. Wursthorn K. Kirschner J. et al. Food intake increases liver stiffness in patients with chronic or resolved hepatitis C virus infection. Liver Int 2009; 29: 1500-1506
• 13 Arena U. Lupsor Platon M. Stasi C. et al. Liver stiffness is influenced by a standardized meal in patients with chronic hepatitis C virus at different stages of fibrotic evolution. Hepatology 2013; 58: 65-72
• 14 Berzigotti A. De Gottardi A. Vukotic R. et al. Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension. PLoS One 2013; 8: e58742
• 15 Gersak MM. Sorantin E. Windhaber J. et al. The influence of acute physical effort on liver stiffness estimation using Virtual Touch Quantification (VTQ). Preliminary results. Med Ultrason 2016; 18: 151-156
• 16 Coco B. Oliveri F. Maina AM. et al. Transient elastography: a new surrogate marker of liver fibrosis influenced by major changes of transaminases. J Viral Hepat 2007; 14: 360-369
• 17 Sagir A. Erhardt A. Schmitt M. et al. Transient elastography is unreliable for detection of cirrhosis in patients with acute liver damage. Hepatology 2008; 47: 592-595
• 18 Arena U. Vizzutti F. Corti G. et al. Acute viral hepatitis increases liver stiffness values measured by transient elastography. Hepatology 2008; 47: 380-384
• 19 Vigano M. Massironi S. Lampertico P. et al. Transient elastography assessment of the liver stiffness dynamics during acute hepatitis B. Eur J Gastroenterol Hepatol 2010; 22: 180-184
• 20 Millonig G. Reimann FM. Friedrich S. et al. Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosis. Hepatology 2008; 48: 1718-1723
• 21 Millonig G. Friedrich S. Adolf S. et al. Liver stiffness is directly influenced by central venous pressure. J Hepatol 2010; 52: 206-210
• 22 Colli A. Pozzoni P. Berzuini A. et al. Decompensated chronic heart failure: increased liver stiffness measured by means of transient elastography. Radiology 2010; 257: 872-878
• 23 Mueller S. Millonig G. Sarovska L. et al. Increased liver stiffness in alcoholic liver disease: differentiating fibrosis from steatohepatitis. World J Gastroenterol 2010; 16: 966-972
• 24 Trabut JB. Thepot V. Nalpas B. et al. Rapid decline of liver stiffness following alcohol withdrawal in heavy drinkers. Alcohol Clin Exp Res 2012; 36: 1407-1411
• 25 Bardou-Jacquet E. Legros L. Soro D. et al. Effect of alcohol consumption on liver stiffness measured by transient elastography. World J Gastroenterol 2013; 19: 516-522
• 26 Petta S. Maida M. Macaluso FS. et al. The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease. Hepatology 2015; 62: 1101-1110
• 27 Macaluso FS. Maida M. Camma C. et al. Steatosis affects the performance of liver stiffness measurement for fibrosis assessment in patients with genotype 1 chronic hepatitis C. J Hepatol 2014; 61: 523-529
• 28 Yoneda M. Yoneda M. Mawatari H. et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD). Dig Liver Dis 2008; 40: 371-378
• 29 Wong VW. Vergniol J. Wong GL. et al. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 2010; 51: 454-462
• 30 Thiele M. Detlefsen S. Sevelsted Moller L. et al. Transient and 2-Dimensional Shear-Wave Elastography Provide Comparable Assessment of Alcoholic Liver Fibrosis and Cirrhosis. Gastroenterology 2016; 150: 123-133
• 31 Cassinotto C. Boursier J. De Ledinghen V. et al. Liver stiffness in nonalcoholic fatty liver disease: A comparison of Supersonic Shear Imaging, FibroScan and ARFI with liver biopsy. Hepatology 2016; 63: 1817-1827
• 32 Zeng J. Liu GJ. Huang ZP. et al. Diagnostic accuracy of two-dimensional shear wave elastography for the non-invasive staging of hepatic fibrosis in chronic hepatitis B: a cohort study with internal validation. Eur Radiol 2014; 24: 2572-2581
• 33 Cassinotto C. Lapuyade B. Mouries A. et al. Noninvasive assessment of liver fibrosis with impulse elastography: comparison of Supersonic Shear Imaging with ARFI and Fibroscan. J Hepatol 2014; 61: 550-557
• 34 Colombo S. Belloli L. Zaccanelli M. et al. Normal liver stiffness and its determinants in healthy blood donors. Dig Liver Dis 2011; 43: 231-236
• 35 Roulot D. Costes JL. Buyck JF. et al. Transient elastography as a screening tool for liver fibrosis and cirrhosis in a community-based population aged over 45 years. Gut 2011; 60: 977-984
• 36 Corpechot C. El Naggar A. Poupon R. Gender and liver: is the liver stiffness weaker in weaker sex?. Hepatology 2006; 44: 513-514
• 37 Sirli R. Sporea I. Tudora A. et al. Transient elastographic evaluation of subjects without known hepatic pathology: does age change the liver stiffness?. J Gastrointestin Liver Dis 2009; 18: 57-60
• 38 Horster S. Mandel P. Zachoval R. et al. Comparing acoustic radiation force impulse imaging to transient elastography to assess liver stiffness in healthy volunteers with and without valsalva manoeuvre. Clin Hemorheol Microcirc 2010; 46: 159-168
• 39 Karlas T. Pfrepper C. Wiegand J. et al. Acoustic radiation force impulse imaging (ARFI) for non-invasive detection of liver fibrosis: examination standards and evaluation of interlobe differences in healthy subjects and chronic liver disease. Scand J Gastroenterol 2011; 46: 1458-1467
• 40 Popescu A. Bota S. Sporea I. et al. The influence of food intake on liver stiffness values assessed by acoustic radiation force impulse elastography-preliminary results. Ultrasound Med Biol 2013; 39: 579-584
• 41 Son CY. Kim SU. Han WK. et al. Normal liver elasticity values using acoustic radiation force impulse imaging: a prospective study in healthy living liver and kidney donors. J Gastroenterol Hepatol 2012; 27: 130-136
• 42 Guzmán-Aroca F. Reus M. Berná-Serna JD. et al. Reproducibility of shear wave velocity measurements by acoustic radiation force impulse imaging of the liver: a study in healthy volunteers. J Ultrasound Med 2011; 30: 975-979
• 43 Toshima T. Shirabe K. Takeishi K. et al. New method for assessing liver fibrosis based on acoustic radiation force impulse: a special reference to the difference between right and left liver. J Gastroenterol 2011; 46: 705-711
• 44 Matos H. Trindade A. Noruegas MJ. Acoustic radiation force impulse imaging in paediatric patients: normal liver values. J Pediatr Gastroenterol Nutr 2014; 59: 684-688
• 45 Hanquinet S. Courvoisier D. Kanavaki A. et al. Acoustic radiation force impulse imaging-normal values of liver stiffness in healthy children. Pediatr Radiol 2013; 43: 539-544
• 46 Ferraioli G. Tinelli C. Lissandrin R. et al. Point shear wave elastography method for assessing liver stiffness. World J Gastroenterol 2014; 20: 4787-4796
• 47 Sporea I. Bota S. Grădinaru-Taşcău O. et al. Comparative study between two point Shear Wave Elastographic techniques: Acoustic Radiation Force Impulse (ARFI) elastography and ElastPQ. Med Ultrason 2014; 16: 309-314
• 48 Ling W. Lu Q. Quan J. et al. Assessment of impact factors on shear wave based liver stiffness measurement. Eur J Radiol 2013; 82: 335-341
• 49 Suh CH. Kim SY. Kim KW. et al. Determination of normal hepatic elasticity by using real-time shear-wave elastography. Radiology 2014; 271: 895-900
• 50 Huang Z. Zheng J. Zeng J. et al. Normal liver stiffness in healthy adults assessed by real-time shear wave elastography and factors that influence this method. Ultrasound Med Biol 2014; 40: 2549-2555
• 51 Dong Y. Sirli R. Ferraioli G. et al. Shear Wave Elastography of the liver, review on normal values. Z Gastroenterol 2017; 55: 153-166
• 52 European Association for Study of L, Asociacion Latinoamericana para el Estudio del H. EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol 2015; 63: 237-264
• 53 Engelmann G. Gebhardt C. Wenning D. et al. Feasibility study and control values of transient elastography in healthy children. Eur J Pediatr 2012; 171: 353-360
• 54 de Ledinghen V. Wong VW. Vergniol J. et al. Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: comparison between M and XL probe of FibroScan(R). J Hepatol 2012; 56: 833-839
• 55 de Ledinghen V. Vergniol J. Foucher J. et al. Feasibility of liver transient elastography with FibroScan using a new probe for obese patients. Liver Int 2010; 30: 1043-1048
• 56 Durango E. Dietrich C. Seitz HK. et al. Direct comparison of the FibroScan XL and M probes for assessment of liver fibrosis in obese and nonobese patients. Hepat Med 2013; 5: 43-52
• 57 Wong VW. Vergniol J. Wong GL. et al. Liver stiffness measurement using XL probe in patients with nonalcoholic fatty liver disease. Am J Gastroenterol 2012; 107: 1862-1871
• 58 Carrion JA. Puigvehi M. Coll S. et al. Applicability and accuracy improvement of transient elastography using the M and XL probes by experienced operators. J Viral Hepat 2015; 22: 297-306
• 59 Lucidarme D. Foucher J. Le Bail B. et al. Factors of accuracy of transient elastography (fibroscan) for the diagnosis of liver fibrosis in chronic hepatitis C. Hepatology 2009; 49: 1083-1089
• 60 Myers RP. Crotty P. Pomier-Layrargues G. et al. Prevalence, risk factors and causes of discordance in fibrosis staging by transient elastography and liver biopsy. Liver Int 2010; 30: 1471-1480
• 61 Myers RP. Pomier-Layrargues G. Kirsch R. et al. Discordance in fibrosis staging between liver biopsy and transient elastography using the FibroScan XL probe. J Hepatol 2012; 56: 564-570
• 62 Fraquelli M. Rigamonti C. Casazza G. et al. Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease. Gut 2007; 56: 968-973
• 63 Boursier J. Konate A. Gorea G. et al. Reproducibility of liver stiffness measurement by ultrasonographic elastometry. Clin Gastroenterol Hepatol 2008; 6: 1263-1269
• 64 Afdhal NH. Bacon BR. Patel K. et al. Accuracy of fibroscan, compared with histology, in analysis of liver fibrosis in patients with hepatitis B or C: a United States multicenter study. Clin Gastroenterol Hepatol 2015; 13: 772-779 e771-e773
• 65 Takahashi H. Ono N. Eguchi Y. et al. Evaluation of acoustic radiation force impulse elastography for fibrosis staging of chronic liver disease: a pilot study. Liver Int 2010; 30: 538-545
• 66 Rizzo L. Calvaruso V. Cacopardo B. et al. Comparison of transient elastography and acoustic radiation force impulse for non-invasive staging of liver fibrosis in patients with chronic hepatitis C. Am J Gastroenterol 2011; 106: 2112-2120
• 67 Piscaglia F. Salvatore V. Di Donato R. et al. Accuracy of VirtualTouch Acoustic Radiation Force Impulse (ARFI) imaging for the diagnosis of cirrhosis during liver ultrasonography. Ultraschall in Med 2011; 32: 167-175
• 68 Goertz RS. Sturm J. Pfeifer L. et al. S. ARFI cut-off values and significance of standard deviation for liver fibrosis staging in patients with chronic liver disease. Ann Hepato 2013; 12: 935-941
• 69 D'Onofrio M. Gallotti A. Mucelli RP. Tissue quantification with acoustic radiation force impulse imaging: Measurement repeatability and normal values in the healthy liver. Am J Roentgenol 2010; 195: 132-136
• 70 Friedrich-Rust M. Wunder K. Kriener S. et al. Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology 2009; 252: 595-604
• 71 Bota S. Sporea I. Sirli R. et al. Intra- and interoperator reproducibility of acoustic radiation force impulse (ARFI) elastography--preliminary results. Ultrasound Med Biol 2012; 38: 1103-1108
• 72 Bota S. Sporea I. Sirli R. et al. Factors which influence the accuracy of acoustic radiation force impulse (ARFI) elastography for the diagnosis of liver fibrosis in patients with chronic hepatitis C. Ultrasound Med Biol 2013; 30: 407-412
• 73 Ferraioli G. Maiocchi L. Lissandrin R. et al. Accuracy of the ElastPQ Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a "Real Life" Single Center Study. J Gastrointestin Liver Dis 2016; 25: 331-335
• 74 Dietrich CF. Dong Y. Shear wave elastography with a new reliability indicator. J Ultrason 2016; 16: 281-287
• 75 Samir AE. Dhyani M. Vij A. et al. Shear-wave elastography for the estimation of liver fibrosis in chronic liver disease: determining accuracy and ideal site for measurement. Radiology 2015; 274: 888-896
• 76 Poynard T. Munteanu M. Luckina E. et al. Liver fibrosis evaluation using real-time shear wave elastography: applicability and diagnostic performance using methods without a gold standard. J Hepatol 2013; 58: 928-935
• 77 Cassinotto C. Charrie A. Mouries A. et al. Liver and spleen elastography using supersonic shear imaging for the non-invasive diagnosis of cirrhosis severity and oesophageal varices. Dig Liver Dis 2015; 47: 695-701
• 78 Cassinotto C. de Lédinghen V. Reply to: “New imaging assisted methods for liver fibrosis quantification: Is it really favorable to classical transient elastography?”. J Hepatol 2015; 63: 767
• 79 Thiele M. Madsen BS. Procopet B. et al. Reliability criteria for liver stiffness measurements with real-time 2D shear wave elastography in different clinical scenarios of chronic liver disease. Ultraschall in Med 2016;
• 80 Sporea I. Gradinaru-Tascau O. Bota S. et al. How many measurements are needed for liver stiffness assessment by 2D-Shear Wave Elastography (2D-SWE) and which value should be used: the mean or median?. Med Ultrason 2013; 15: 268-272
• 81 Sporea I. Bota S. Jurchis A. et al. Acoustic radiation force impulse and supersonic shear imaging versus transient elastography for liver fibrosis assessment. Ultrasound Med Biol 2013; 39: 1933-1941
• 82 Yoon JH. Lee JM. Han JK. et al. Shear wave elastography for liver stiffness measurement in clinical sonographic examinations: evaluation of intraobserver reproducibility, technical failure, and unreliable stiffness measurements. J Ultrasound Med 2014; 33: 437-447
• 83 Hudson JM. Milot L. Parry C. et al. Inter- and intra-operator reliability and repeatability of shear wave elastography in the liver: a study in healthy volunteers. Ultrasound in Med & Biol 2013; 39: 950-955
• 84 Ferraioli G. Tinelli C. Zicchetti M. et al. Reproducibility of real-time shear wave elastography in the evaluation of liver elasticity. Eur J Radiol 2012; 81: 3102-3106
• 85 Woo H. Lee JY. Yoon JH. et al. Comparison of the Reliability of Acoustic Radiation Force Impulse Imaging and Supersonic Shear Imaging in Measurement of Liver Stiffness. Radiology 2015; 277: 881-886
• 86 Staugaard B. Christensen PB. Mossner B. et al. Feasibility of transient elastography versus real-time two-dimensional shear wave elastography in difficult-to-scan patients. Scand J Gastroenterol 2016; 51: 1354-1359
• 87 Hall TJ. Milkowski A. Garra B. et al. RSNA/QIBA: shear wave speed as a biomarker for liver fibrosis staging. In: Ultrasonics Symposium (IUS), 2013. I.E. International; 2013: 397-400
• 88 Palmeri M. Nightingale K. Fielding S. et al. RSNA QIBA ultrasound shear wave speed Phase II phantom study in viscoelastic media. Proceedings of the 2015 IEEE Ultrasonics Symposium, 2015. International; 2013: 397-400
• 89 Chang S. Kim MJ. Kim J. et al. Variability of shear wave velocity using different frequencies in acoustic radiation force impulse (ARFI) elastography: a phantom and normal liver study. Ultraschall in Med 2013; 34: 260-265
• 90 Potthoff A. Attia D. Pischke S. et al. Influence of different frequencies and insertion depths on the diagnostic accuracy of liver elastography by acoustic radiation force impulse imaging (ARFI). Eur J Radiol 2013; 82: 1207-1212
• 91 Ferraioli G. Lissandrin R. Zicchetti M. et al. Ultrasound point shear wave elastography assessment of liver and spleen stiffness: effect of training on repeatability of measurements. Eur Radiol 2014; 24: 1283-1289
• 92 Ma JJ. Ding H. Mao F. et al. Assessment of liver fibrosis with elastography point quantification technique in chronic hepatitis B virus patients: a comparison with liver pathological results. J Gastroenterol Hepatol 2014; 29: 814-819
• 93 Fraquelli M. Baccarin A. Casazza G. et al. Liver stiffness measurement reliability and main determinants of point shear-wave elastography in patients with chronic liver disease. Aliment Pharmacol Ther 2016; 44: 356-365
• 94 Piscaglia F. Salvatore V. Mulazzani L. et al. Ultrasound Shear Wave Elastography for Liver Disease. A Critical Appraisal of the Many Actors on the Stage. Ultraschall in Med 2016; 37: 1-5
• 95 Friedrich-Rust M. Ong MF. Martens S. et al. Performance of transient elastography for the staging of liver fibrosis: a meta-analysis. Gastroenterology 2008; 134: 960-974
• 96 Chang PE. Goh GB. Ngu JH. et al. Clinical applications, limitations and future role of transient elastography in the management of liver disease. World J Gastrointest Pharmacol Ther 2016; 7: 91-106
• 97 Tsochatzis EA. Gurusamy KS. Ntaoula S. et al. Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy. J Hepatol 2011; 54: 650-659
• 98 Njei B. McCarty TR. Luk J. et al. Use of Transient Elastography in Patients with HIV-HCV Co-infection: A Systematic Review and Meta-analysis. J Gastroenterol Hepatol 2016; 31: 1684-1693
• 99 Barrault C. Roudot-Thoraval F. Tran Van Nhieu J. et al. Non-invasive assessment of liver graft fibrosis by transient elastography after liver transplantation. Clin Res Hepatol Gastroenterol 2013; 37: 347-352
• 100 European Association for Study of L. EASL Clinical Practice Guidelines: management of hepatitis C virus infection. J Hepatol 2014; 60: 392-420
• 101 Sporea I. Bota S. Peck-Radosavljevic M. et al. Acoustic Radiation Force Impulse elastography for fibrosis evaluation in patients with chronic hepatitis C: an international multicenter study. Eur J Radiol 2012; 81: 4112-4118
• 102 Friedrich-Rust M. Lupsor M. de Knegt R. et al. Point Shear Wave Elastography by Acoustic Radiation Force Impulse Quantification in Comparison to Transient Elastography for the Noninvasive Assessment of Liver Fibrosis in Chronic Hepatitis C: A Prospective International Multicenter Study. Ultraschall in Med 2015; 36: 239-247
• 103 Friedrich-Rust M. Nierhoff J. Lupsor M. et al. Performance of Acoustic Radiation Force Impulse imaging for the staging of liver fibrosis: a pooled meta-analysis. J Viral Hepat 2012; 19: e212-e219
• 104 Conti F. Serra C. Vukotic R. et al. Accuracy of elastography point quantification and steatosis influence on assessing liver fibrosis in patients with chronic hepatitis C. Liver Int 2017; 37: 187-195
• 105 Joo SK. Kim JH. Oh S. et al. Prospective Comparison of Noninvasive Fibrosis Assessment to Predict Advanced Fibrosis or Cirrhosis in Asian Patients With Hepatitis C. J Clin Gastroenterol 2015; 49: 697-704
• 106 Ferraioli G. Tinelli C. Dal Bello B. et al. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Hepatology 2012; 56: 2125-2133
• 107 Bavu E. Gennisson JL. Couade M. et al. Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: a clinical study on 113 hepatitis C virus patients. Ultrasound Med Biol 2011; 37: 1361-1373
• 108 Tada T. Kumada T. Toyoda H. et al. Utility of real-time shear wave elastography for assessing liver fibrosis in patients with chronic hepatitis C infection without cirrhosis: Comparison of liver fibrosis indices. Hepatol Res 2015; 45: 122-129
• 109 Yoneda M. Thomas E. Sclair SN. et al. Supersonic shear imaging and transient elastography with the XL probe accurately detect fibrosis in overweight or obese patients with chronic liver disease. Clin Gastroenterol Hepatol 2015; 13: 1502-1509 e1505
• 110 Vergniol J. Foucher J. Terrebonne E. et al. Noninvasive tests for fibrosis and liver stiffness predict 5-year outcomes of patients with chronic hepatitis C. Gastroenterology 2011; 140: 1970-1979
• 111 Macias J. Camacho A. Von Wichmann MA. et al. Liver stiffness measurement versus liver biopsy to predict survival and decompensations of cirrhosis among HIV/hepatitis C virus-coinfected patients. AIDS 2013; 27: 2541-2549
• 112 Masuzaki R. Tateishi R. Yoshida H. et al. Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography. Hepatology 2009; 49: 1954-1961
• 113 Poynard T. Vergniol J. Ngo Y. et al. Staging chronic hepatitis C in seven categories using fibrosis biomarker (FibroTest) and transient elastography (FibroScan(R)). J Hepatol 2014; 60: 706-714
• 114 Narita Y. Genda T. Tsuzura H. et al. Prediction of liver stiffness hepatocellular carcinoma in chronic hepatitis C patients on interferon-based anti-viral therapy. J Gastroenterol Hepatol 2014; 29: 137-143
• 115 Crespo G. Lens S. Gambato M. et al. Liver stiffness 1 year after transplantation predicts clinical outcomes in patients with recurrent hepatitis C. Am J Transplant 2014; 14: 375-383
• 116 Carrion JA. Navasa M. Bosch J. et al. Transient elastography for diagnosis of advanced fibrosis and portal hypertension in patients with hepatitis C recurrence after liver transplantation. Liver Transpl 2006; 12: 1791-1798
• 117 Stasi C. Piluso A. Arena U. et al. Evaluation of the prognostic value of liver stiffness in patients with hepatitis C virus treated with triple or dual antiviral therapy: A prospective pilot study. World J Gastroenterol 2015; 21: 3013-3019
• 118 Yada N. Sakurai T. Minami T. et al. Ultrasound elastography correlates treatment response by antiviral therapy in patients with chronic hepatitis C. Oncology 2014; 87 (Suppl. 01) 118-123
• 119 Mandorfer M. Kozbial K. Freissmuth C. et al. Interferon-free regimens for chronic hepatitis C overcome the effects of portal hypertension on virological responses. Aliment Pharmacol Ther 2015; 42: 707-718
• 120 Deterding K. Schlevogt B. Port K. et al. Letter: can persisting liver stiffness indicate increased risk of hepatocellular cell carcinoma after successful anti-HCV therapy? – authors' reply. Aliment Pharmacol Ther 2016; 43: 546-547
• 121 Hezode C. Castera L. Roudot-Thoraval F. et al. Liver stiffness diminishes with antiviral response in chronic hepatitis C. Aliment Pharmacol Ther 2011; 34: 656-663
• 122 Lee HW. Chon YE. Kim SU. et al. Predicting Liver-Related Events Using Transient Elastography in Chronic Hepatitis C Patients with Sustained Virological Response. Gut Liver 2016; 10: 429-436
• 123 D'Ambrosio R. Aghemo A. Fraquelli M. et al. The diagnostic accuracy of Fibroscan for cirrhosis is influenced by liver morphometry in HCV patients with a sustained virological response. J Hepatol 2013; 59: 251-256
• 124 Osakabe K. Ichino N. Nishikawa T. et al. Changes of shear-wave velocity by interferon-based therapy in chronic hepatitis C. World J Gastroenterol 2015; 21: 10215-10223
• 125 Goertz RS. Sturm J. Zopf S. et al. Outcome analysis of liver stiffness by ARFI (acoustic radiation force impulse) elastometry in patients with chronic viral hepatitis B and C. Clin Radiol 2014; 69: 275-279
• 126 Yamada R. Hiramatsu N. Oze T. et al. Significance of liver stiffness measurement by acoustic radiation force impulse (ARFI) among hepatitis C patients. J Med Virol 2014; 86: 241-247
• 127 Liver EAFTSOT. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol 2012; 57: 167-185
• 128 Chon YE. Choi EH. Song KJ. et al. Performance of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B: a meta-analysis. PLoS One 2012; 7: e44930
• 129 Xu X. Su Y. Song R. et al. Performance of transient elastography assessing fibrosis of single hepatitis B virus infection: a systematic review and meta-analysis of a diagnostic test. Hepatol Int 2015; 9: 558-566
• 130 Li Y. Huang YS. Wang ZZ. et al. Systematic review with meta-analysis: the diagnostic accuracy of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B. Aliment Pharmacol Ther 2016; 43: 458-469
• 131 Seo YS. Kim MN. Kim SU. et al. Risk Assessment of Hepatocellular Carcinoma Using Transient Elastography Vs. Liver Biopsy in Chronic Hepatitis B Patients Receiving Antiviral Therapy. Medicine (Baltimore) 2016; 95: e2985
• 132 Meng F. Zheng Y. Zhang Q. et al. Noninvasive evaluation of liver fibrosis using real-time tissue elastography and transient elastography (FibroScan). J Ultrasound Med 2015; 34: 403-410
• 133 Liu Y. Dong CF. Yang G. et al. Optimal linear combination of ARFI, transient elastography and APRI for the assessment of fibrosis in chronic hepatitis B. Liver Int 2015; 35: 816-825
• 134 Dong DR. Hao MN. Li C. et al. Acoustic radiation force impulse elastography, FibroScan(R), Forns' index and their combination in the assessment of liver fibrosis in patients with chronic hepatitis B, and the impact of inflammatory activity and steatosis on these diagnostic methods. Mol Med Rep 2015; 11: 4174-4182
• 135 Chan HL. Wong GL. Choi PC. et al. Alanine aminotransferase-based algorithms of liver stiffness measurement by transient elastography (Fibroscan) for liver fibrosis in chronic hepatitis B. J Viral Hepat 2009; 16: 36-44
• 136 Cardoso AC. Carvalho-Filho RJ. Stern C. et al. Direct comparison of diagnostic performance of transient elastography in patients with chronic hepatitis B and chronic hepatitis C. Liver Int 2012; 32: 612-621
• 137 Fraquelli M. Rigamonti C. Casazza G. et al. Etiology-related determinants of liver stiffness values in chronic viral hepatitis B or C. J Hepatol 2011; 54: 621-628
• 138 Invernizzi F. Vigano M. Grossi G. et al. The prognosis and management of inactive HBV carriers. Liver Int 2016; 36 (Suppl. 01) 100-104
• 139 Castera L. Bernard PH. Le Bail B. et al. Transient elastography and biomarkers for liver fibrosis assessment and follow-up of inactive hepatitis B carriers. Aliment Pharmacol Ther 2011; 33: 455-465
• 140 Dong CF. Xiao J. Shan LB. et al. Combined acoustic radiation force impulse, aminotransferase to platelet ratio index and Forns index assessment for hepatic fibrosis grading in hepatitis B. World J Hepatol 2016; 8: 616-624
• 141 Nierhoff J. Chavez Ortiz AA. Herrmann E. et al. The efficiency of acoustic radiation force impulse imaging for the staging of liver fibrosis: a meta-analysis. Eur Radiol 2013; 23: 3040-3053
• 142 Ding H. Ma JJ. Wang WP. et al. Assessment of liver fibrosis: the relationship between point shear wave elastography and quantitative histological analysis. J Gastroenterol Hepatol 2015; 30: 553-558
• 143 Lu Q. Lu C. Li J. et al. Stiffness values and serum biomarkers in liver fibrosis staging: study in large surgical specimens in patients with chronic Hepatitis B. Radiology 2016; 280: 290-299
• 144 Yegin EG. Yegin K. Karatay E. et al. Quantitative assessment of liver fibrosis by digital image analysis: Relationship to Ishak staging and elasticity by shear-wave elastography. J Dig Dis 2015; 16: 217-227
• 145 Leung VY. Shen J. Wong VW. et al. Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: comparison of shear-wave elastography and transient elastography with liver biopsy correlation. Radiology 2013; 269: 910-918
• 146 Feng JC. Li J. Wu XW. et al. Diagnostic Accuracy of SuperSonic Shear Imaging for Staging of Liver Fibrosis: A Meta-analysis. J Ultrasound Med 2016; 35: 329-339
• 147 Li C. Zhang C. Li J. et al. Diagnostic Accuracy of Real-Time Shear Wave Elastography for Staging of Liver Fibrosis: A Meta-Analysis. Med Sci Monit 2016; 22: 1349-1359
• 148 Kim MN. Kim SU. Kim BK. et al. Long-term changes of liver stiffness values assessed using transient elastography in patients with chronic hepatitis B receiving entecavir. Liver Int 2014; 34: 1216-1223
• 149 Yo IK. Kwon OS. Park JW. et al. The factors associated with longitudinal changes in liver stiffness in patients with chronic hepatitis B. Clin Mol Hepatol 2015; 21: 32-40
• 150 Park MS. Kim SU. Kim BK. et al. Prognostic value of the combined use of transient elastography and fibrotest in patients with chronic hepatitis B. Liver Int 2015; 35: 455-462
• 151 Kim MN. Kim SU. Park JY. et al. Risk assessment of liver-related events using transient elastography in patients with chronic hepatitis B receiving entecavir. J Clin Gastroenterol 2014; 48: 272-278
• 152 Shin SH. Kim SU. Park JY. et al. Liver stiffness-based model for prediction of hepatocellular carcinoma in chronic hepatitis B virus infection: comparison with histological fibrosis. Liver Int 2015; 35: 1054-1062
• 153 Wong GL. Chan HL. Wong CK. et al. Liver stiffness-based optimization of hepatocellular carcinoma risk score in patients with chronic hepatitis B. J Hepatol 2014; 60: 339-345
• 154 Lee HW. Yoo EJ. Kim BK. et al. Prediction of development of liver-related events by transient elastography in hepatitis B patients with complete virological response on antiviral therapy. Am J Gastroenterol 2014; 109: 1241-1249
• 155 Kim MN. Kim SU. Kim BK. et al. Increased risk of hepatocellular carcinoma in chronic hepatitis B patients with transient elastography-defined subclinical cirrhosis. Hepatology 2015; 61: 1851-1859
• 156 Petta S. Vanni E. Bugianesi E. et al. The combination of liver stiffness measurement and NAFLD fibrosis score improves the noninvasive diagnostic accuracy for severe liver fibrosis in patients with nonalcoholic fatty liver disease. Liver Int 2015; 35: 1566-1573
• 157 Naveau S. Lamouri K. Pourcher G. et al. The diagnostic accuracy of transient elastography for the diagnosis of liver fibrosis in bariatric surgery candidates with suspected NAFLD. Obes Surg 2014; 24: 1693-1701
• 158 Tapper EB. Challies T. Nasser I. et al. The Performance of Vibration Controlled Transient Elastography in a US Cohort of Patients With Nonalcoholic Fatty Liver Disease. Am J Gastroenterol 2016; 111: 677-684
• 159 Kumar R. Rastogi A. Sharma MK. et al. Liver stiffness measurements in patients with different stages of nonalcoholic fatty liver disease: diagnostic performance and clinicopathological correlation. Dig Dis Sci 2013; 58: 265-274
• 160 Kwok R. Tse YK. Wong GL. et al. Systematic review with meta-analysis: non-invasive assessment of non-alcoholic fatty liver disease--the role of transient elastography and plasma cytokeratin-18 fragments. Aliment Pharmacol Ther 2014; 39: 254-269
• 161 Liu H. Fu J. Hong R. et al. Acoustic Radiation Force Impulse Elastography for the Non-Invasive Evaluation of Hepatic Fibrosis in Non-Alcoholic Fatty Liver Disease Patients: A Systematic Review & Meta-Analysis. PLoS One 2015; 10: e0127782
• 162 Zheng J. Guo H. Zeng J. et al. Two-dimensional shear-wave elastography and conventional US: the optimal evaluation of liver fibrosis and cirrhosis. Radiology 2015; 275: 290-300
• 163 Boursier J. Vergniol J. Guillet A. et al. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by Fibroscan in non-alcoholic fatty liver disease. J Hepatol 2016; 65: 570-578
• 164 Pavlov CS. Casazza G. Nikolova D. et al. Transient elastography for diagnosis of stages of hepatic fibrosis and cirrhosis in people with alcoholic liver disease. Cochrane Database Syst Rev 2015; 1: CD010542
• 165 Nahon P. Kettaneh A. Tengher-Barna I. et al. Assessment of liver fibrosis using transient elastography in patients with alcoholic liver disease. J Hepatol 2008; 49: 1062-1068
• 166 Nguyen-Khac E. Chatelain D. Tramier B. et al. Assessment of asymptomatic liver fibrosis in alcoholic patients using fibroscan: prospective comparison with seven non-invasive laboratory tests. Aliment Pharmacol Ther 2008; 28: 1188-1198
• 167 Kim SG. Kim YS. Jung SW. et al. The usefulness of transient elastography to diagnose cirrhosis in patients with alcoholic liver disease. Korean J Hepatol 2009; 15: 42-51
• 168 Janssens F. de Suray N. Piessevaux H. et al. Can transient elastography replace liver histology for determination of advanced fibrosis in alcoholic patients: a real-life study. J Clin Gastroenterol 2010; 44: 575-582
• 169 Fernandez M. Trepo E. Degre D. et al. Transient Elastography using Fibroscan is the most reliable noninvasive method for the diagnosis of advanced fibrosis and cirrhosis in alcoholic liver disease. Eur J Gastroenterol Hepatol 2015; 27: 1074-1079
• 170 Mueller S. Englert S. Seitz HK. et al. Inflammation-adapted liver stiffness values for improved fibrosis staging in patients with hepatitis C virus and alcoholic liver disease. Liver International 2015; 35: 2514-2521
• 171 Cho EJ. Kim MY. Lee JH. et al. Diagnostic and Prognostic Values of Noninvasive Predictors of Portal Hypertension in Patients with Alcoholic Cirrhosis. PLoS One 2015; 10: e0133935
• 172 Sporea I. Ratiu I. Bota S. et al. Are different cut-off values of liver stiffness assessed by transient elastography according to the etiology of liver cirrhosis for predicting significant esophageal varices?. Med Ultrason 2013; 15: 111-115
• 173 Gelsi E. Dainese R. Truchi R. et al. Effect of detoxification on liver stiffness assessed by Fibroscan(R) in alcoholic patients. Alcohol Clin Exp Res 2011; 35: 566-570
• 174 Harman DJ. Ryder SD. James MW. et al. Direct targeting of risk factors significantly increases the detection of liver cirrhosis in primary care: a cross-sectional diagnostic study utilising transient elastography. BMJ Open 2015; 5: e007516
• 175 Bellentani S. Saccoccio G. Costa G. et al. Drinking habits as cofactors of risk for alcohol induced liver damage. Gut 1997; 41: 845-850
• 176 Kiani A. Brun V. Laine F. et al. Acoustic radiation force impulse imaging for assessing liver fibrosis in alcoholic liver disease. World J Gastroenterol 2016; 22: 4926-4935
• 177 Zhang D. Li P. Chen M. et al. Non-invasive assessment of liver fibrosis in patients with alcoholic liver disease using acoustic radiation force impulse elastography. Abdom Imaging 2015; 40: 723-729
• 178 Liu F. Wei L. Tang X. et al. Clinical value of virtual touch tissue quantification and PGA index in evaluation of alcoholic liver fibrosis. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2015; 40: 1246-1252
• 179 Corpechot C. Carrat F. Poujol-Robert A. et al. Noninvasive elastography-based assessment of liver fibrosis progression and prognosis in primary biliary cirrhosis. Hepatology 2012; 56: 198-208
• 180 Corpechot C. El Naggar A. Poujol-Robert A. et al. Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC. Hepatology 2006; 43: 1118-1124
• 181 Wang QX. Shen L. Qiu DK. et al. Validation of transient elastography (Fibroscan) in assessment of hepatic fibrosis in autoimmune hepatitis. Zhonghua Gan Zang Bing Za Zhi 2011; 19: 782-784
• 182 Corpechot C. Gaouar F. El Naggar A. et al. Baseline values and changes in liver stiffness measured by transient elastography are associated with severity of fibrosis and outcomes of patients with primary sclerosing cholangitis. Gastroenterology 2014; 146: 970-979 quiz e915–976
• 183 Colecchia A. Di Biase AR. Scaioli E. et al. Non-invasive methods can predict oesophageal varices in patients with biliary atresia after a Kasai procedure. Dig Liver Dis 2011; 43: 659-663
• 184 Righi S. Fiorini E. De Molo C. et al. ARFI elastography in patients with chronic autoimmune liver diseases: A preliminary study. J Ultrasound 2012; 15: 226-231
• 185 Efe C. Gungoren MS. Ozaslan E. et al. Acoustic Radiation Force Impulse (ARFI) for Fibrosis Staging in Patients with Autoimmune Hepatitis. Hepatogastroenterology 2015; 62: 670-672
• 186 Zhang DK. Chen M. Liu Y. et al. Acoustic radiation force impulse elastography for non-invasive assessment of disease stage in patients with primary biliary cirrhosis: A preliminary study. Clin Radiol 2014; 69: 836-840
• 187 Wang X. Qian L. Jia L. et al. Utility of Shear Wave Elastography for Differentiating Biliary Atresia From Infantile Hepatitis Syndrome. J Ultrasound Med 2016; 35: 1475-1479
• 188 Shi KQ. Fan YC. Pan ZZ. et al. Transient elastography: a meta-analysis of diagnostic accuracy in evaluation of portal hypertension in chronic liver disease. Liver Int 2013; 33: 62-71
• 189 Robic MA. Procopet B. Metivier S. et al. Liver stiffness accurately predicts portal hypertension related complications in patients with chronic liver disease: a prospective study. J Hepatol 2011; 55: 1017-1024
• 190 Berzigotti A. Seijo S. Arena U. et al. Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis. Gastroenterology 2013; 144: 102-111
• 191 Takuma Y. Nouso K. Morimoto Y. et al. Measurement of spleen stiffness by acoustic radiation force impulse imaging identifies cirrhotic patients with esophageal varices. Gastroenterology 2013; 144: 92-101 e102
• 192 Augustin S. Millan L. Gonzalez A. et al. Detection of early portal hypertension with routine data and liver stiffness in patients with asymptomatic liver disease: a prospective study. J Hepatol 2014; 60: 561-569
• 193 Ding NS. Nguyen T. Iser DM. et al. Liver stiffness plus platelet count can be used to exclude high-risk oesophageal varices. Liver Int 2016; 36: 240-245
• 194 de Franchis R. Baveno VIF. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol 2015; 63: 743-752
• 195 Attia D. Schoenemeier B. Rodt T. et al. Evaluation of Liver and Spleen Stiffness with Acoustic Radiation Force Impulse Quantification Elastography for Diagnosing Clinically Significant Portal Hypertension. Ultraschall in Med 2015; 36: 603-610
• 196 Salzl P. Reiberger T. Ferlitsch M. et al. Evaluation of portal hypertension and varices by acoustic radiation force impulse imaging of the liver compared to transient elastography and AST to platelet ratio index. Ultraschall in Med 2014; 35: 528-533
• 197 Takuma Y. Nouso K. Morimoto Y. et al. Portal Hypertension in Patients with Liver Cirrhosis: Diagnostic Accuracy of Spleen Stiffness. Radiology 2016; 279: 609-619
• 198 Elkrief L. Rautou PE. Ronot M. et al. Prospective Comparison of Spleen and Liver Stiffness by Using Shear-Wave and Transient Elastography for Detection of Portal Hypertension in Cirrhosis. Radiology 2015; 275: 589-598
• 199 Kim TY. Jeong WK. Sohn JH. et al. Evaluation of portal hypertension by real-time shear wave elastography in cirrhotic patients. Liver Int 2015; 35: 2416-2424
• 200 Jansen C. Bogs C. Verlinden W. et al. Algorithm to rule out clinically significant portal hypertension combining Shear-wave elastography of liver and spleen: a prospective multicentre study. Gut 2016; 65: 1057-1058
• 201 Choi SY. Jeong WK. Kim Y. et al. Shear-Wave Elastography: A Noninvasive Tool for Monitoring Changing Hepatic Venous Pressure Gradients in Patients with Cirrhosis. Radiology 2014; 273: 917-926