Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement.

The Society of Radiologists in Ultrasound convened a panel of specialists from radiology, hepatology, pathology, and basic science and physics to arrive at a consensus regarding the use of elastography in the assessment of liver fibrosis in chronic liver disease. The panel met in Denver, Colo, on October 21-22, 2014, and drafted this consensus statement. The recommendations in this statement are based on analysis of current literature and common practice strategies and are thought to represent a reasonable approach to the noninvasive assessment of diffuse liver fibrosis.

[1]  F. Brunello,et al.  Reliability of transient elastography for the detection of fibrosis in non-alcoholic fatty liver disease and chronic viral hepatitis. , 2011, Journal of hepatology.

[2]  Sabrina Fox‐Bosetti,et al.  Test–retest repeatability of MR elastography for noninvasive liver fibrosis assessment in hepatitis C , 2011, Journal of magnetic resonance imaging : JMRI.

[3]  Xavier Forns,et al.  Longitudinal Liver Stiffness Assessment in Patients with Chronic Hepatitis C Undergoing Antiviral Therapy , 2012, PloS one.

[4]  Gunda Millonig,et al.  Liver stiffness is directly influenced by central venous pressure. , 2010, Journal of hepatology.

[5]  J. Bruix,et al.  Management of hepatocellular carcinoma , 2005, Hepatology.

[6]  A. Craxì,et al.  Hepatic steatosis and insulin resistance are associated with severe fibrosis in patients with chronic hepatitis caused by HBV or HCV infection , 2011, Liver international : official journal of the International Association for the Study of the Liver.

[7]  J. Talwalkar,et al.  Accuracy of spleen stiffness measurement in detection of esophageal varices in patients with chronic liver disease: systematic review and meta-analysis. , 2014, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[8]  E. Giannini,et al.  Trial sequence meta‐analysis can reject false‐positive result calculated from conventional meta‐analysis , 2014, Hepatology.

[9]  V. de Lédinghen,et al.  Comparison of eight diagnostic algorithms for liver fibrosis in hepatitis C: new algorithms are more precise and entirely noninvasive , 2012, Hepatology.

[10]  Mohammad Hassan Murad,et al.  Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. , 2015, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[11]  R. Ehman,et al.  Magnetic resonance elastography of liver: Technique, analysis, and clinical applications , 2013, Journal of magnetic resonance imaging : JMRI.

[12]  EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. , 2012, Journal of hepatology.

[13]  O H Gilja,et al.  EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography.Part 2: Clinical Applications , 2013, Ultraschall in der Medizin.

[14]  Vincent Wai-Sun Wong,et al.  Hepatitis B virus genotype C is associated with more severe liver fibrosis than genotype B. , 2009, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[15]  H. Kirikoshi,et al.  Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD). , 2008, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[16]  Pierre Bedossa,et al.  Non‐invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B , 2009, Liver international : official journal of the International Association for the Study of the Liver.

[17]  R. Myers,et al.  FibroTest and FibroScan for the Prediction of Hepatitis C-Related Fibrosis: A Systematic Review of Diagnostic Test Accuracy , 2007, The American Journal of Gastroenterology.

[18]  Dario Conte,et al.  Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease , 2007, Gut.

[19]  Ioan Sporea,et al.  Intra- and interoperator reproducibility of acoustic radiation force impulse (ARFI) elastography--preliminary results. , 2012, Ultrasound in medicine & biology.

[20]  Julien Vergniol,et al.  Non-invasive assessment of liver fibrosis with impulse elastography: comparison of Supersonic Shear Imaging with ARFI and FibroScan®. , 2014, Journal of hepatology.

[21]  S. Zeuzem,et al.  EASL Clinical Practice Guidelines: management of hepatitis C virus infection. , 2014, Journal of hepatology.

[22]  Richard D Moore,et al.  Assessment of liver fibrosis by transient elastography in persons with hepatitis C virus infection or HIV-hepatitis C virus coinfection. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[23]  S. Bota,et al.  Is it better to use two elastographic methods for liver fibrosis assessment? , 2011, World journal of gastroenterology.

[24]  S. Emelianov,et al.  Shear wave elasticity imaging: a new ultrasonic technology of medical diagnostics. , 1998, Ultrasound in medicine & biology.

[25]  J. Bosch,et al.  Real-time shear-wave elastography: applicability, reliability and accuracy for clinically significant portal hypertension. , 2015, Journal of hepatology.

[26]  G. Casazza,et al.  Etiology-related determinants of liver stiffness values in chronic viral hepatitis B or C. , 2011, Journal of hepatology.

[27]  Ioan Sporea,et al.  Meta‐analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis , 2013, Liver international : official journal of the International Association for the Study of the Liver.

[28]  M. Brunetto,et al.  Liver stiffness in the hepatitis B virus carrier: a non-invasive marker of liver disease influenced by the pattern of transaminases. , 2008, World journal of gastroenterology.

[29]  D A Clevert,et al.  Comparing acoustic radiation force impulse imaging to transient elastography to assess liver stiffness in healthy volunteers with and without valsalva manoeuvre. , 2010, Clinical hemorheology and microcirculation.

[30]  M. Ziol,et al.  Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC , 2006, Hepatology.

[31]  R Moreno-Otero,et al.  Transient elastography: a valid alternative to biopsy in patients with chronic liver disease , 2006, Alimentary pharmacology & therapeutics.

[32]  D. Rubens,et al.  Shear wave dispersion measures liver steatosis. , 2012, Ultrasound in medicine & biology.

[33]  E. Schiff,et al.  Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection , 2002, American Journal of Gastroenterology.

[34]  Laurent Castera,et al.  Accuracy of liver stiffness measurement for the diagnosis of cirrhosis in patients with chronic liver diseases , 2006, Hepatology.

[35]  C. Corpechot,et al.  Gender and liver: Is the liver stiffness weaker in weaker sex? , 2006, Hepatology.

[36]  H. Makhlouf,et al.  Pathologic criteria for nonalcoholic steatohepatitis: Interprotocol agreement and ability to predict liver‐related mortality , 2011, Hepatology.

[37]  E. Tapper,et al.  FibroScan (vibration-controlled transient elastography): where does it stand in the United States practice. , 2015, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[38]  Ioan Sporea,et al.  EFSUMB Guidelines and Recommendations on the Clinical , 2017 .

[39]  S. Milani,et al.  Reliability of transient elastography for the diagnosis of advanced fibrosis in chronic hepatitis C , 2008, Gut.

[40]  V. de Lédinghen,et al.  Determination of reliability criteria for liver stiffness evaluation by transient elastography , 2013, Hepatology.

[41]  G E Trahey,et al.  In vivo visualization of abdominal malignancies with acoustic radiation force elastography , 2008, Physics in medicine and biology.

[42]  Z. Goodman.  Grading and staging systems for inflammation and fibrosis in chronic liver diseases. , 2007, Journal of hepatology.

[43]  M. Bilodeau,et al.  An update on the management of hepatitis C: consensus guidelines from the Canadian Association for the Study of the Liver. , 2012, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[44]  Julien Vergniol,et al.  Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease , 2010, Hepatology.

[45]  L. Sobin,et al.  The morphology of cirrhosis: definition, nomenclature, and classification. , 1977, Bulletin of the World Health Organization.

[46]  J. Macías,et al.  The use of transient elastometry for assessing liver fibrosis in patients with HIV and hepatitis C virus coinfection. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[47]  M. Yin,et al.  Cross-vendor validation of liver magnetic resonance elastography , 2015, Abdominal Imaging.

[48]  Mark Palmeri,et al.  Parameters affecting the resolution and accuracy of 2-D quantitative shear wave images , 2012, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[49]  B. Garra.  Elastography: Current Status, Future Prospects, and Making It Work for You , 2011, Ultrasound quarterly.

[50]  B. Stotland,et al.  Liver biopsy complications and routine ultrasound. , 1996, The American journal of gastroenterology.

[51]  Mathias Fink,et al.  Early detection of steatohepatitis in fatty rat liver by using MR elastography. , 2009, Radiology.

[52]  Kunihiro Hosono,et al.  Nonalcoholic fatty liver disease: US-based acoustic radiation force impulse elastography. , 2010, Radiology.

[53]  R. Nelson,et al.  Acoustic radiation force impulse imaging of the abdomen: demonstration of feasibility and utility. , 2005, Ultrasound in medicine & biology.

[54]  R. Standish,et al.  An appraisal of the histopathological assessment of liver fibrosis , 2006, Gut.

[55]  F. Marra,et al.  Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis , 2008, Hepatology.

[56]  Tsuyoshi Shiina,et al.  WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 3: liver. , 2015, Ultrasound in medicine & biology.

[57]  D. Ndububa,et al.  Management of Hepatocellular carcinoma , 2015 .

[58]  Abdullah Alturki,et al.  RSNA/QIBA: Shear wave speed as a biomarker for liver fibrosis staging , 2013, 2013 IEEE International Ultrasonics Symposium (IUS).

[59]  F. Carrat,et al.  Noninvasive elastography‐based assessment of liver fibrosis progression and prognosis in primary biliary cirrhosis , 2012, Hepatology.

[60]  Radu Badea,et al.  Analysis of histopathological changes that influence liver stiffness in chronic hepatitis C. Results from a cohort of 324 patients. , 2008, Journal of gastrointestinal and liver diseases : JGLD.

[61]  Mathieu Couade,et al.  Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: a clinical study on 113 hepatitis C virus patients. , 2011, Ultrasound in medicine & biology.

[62]  M. Fink,et al.  The variance of quantitative estimates in shear wave imaging: Theory and experiments , 2012, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[63]  D. Rubens,et al.  Mouse liver dispersion for the diagnosis of early-stage Fatty liver disease: a 70-sample study. , 2014, Ultrasound in medicine & biology.

[64]  J. Macías,et al.  Liver Stiffness as a Predictor of Esophageal Varices Requiring Therapy in HIV/Hepatitis C Virus-Coinfected Patients With Cirrhosis , 2009, Journal of acquired immune deficiency syndromes.

[65]  Chang Duck Kim,et al.  The effect of the respiratory cycle on liver stiffness values as measured by transient elastography , 2011, Journal of viral hepatitis.

[66]  M. Manns,et al.  Food intake increases liver stiffness in patients with chronic or resolved hepatitis C virus infection , 2009, Liver international : official journal of the International Association for the Study of the Liver.

[67]  G. Ferraioli,et al.  Ultrasound point shear wave elastography assessment of liver and spleen stiffness: effect of training on repeatability of measurements , 2014, European Radiology.

[68]  Christos Christidis,et al.  Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C , 2005, Hepatology.

[69]  Laurent Castera,et al.  Non-invasive evaluation of liver fibrosis using transient elastography. , 2008, Journal of hepatology.

[70]  M. Campbell,et al.  Noninvasive Assessment of Liver Fibrosis by Measurement of Stiffness in Patients With Chronic Hepatitis C , 2006 .

[71]  Pengfei Song,et al.  Bias observed in time-of-flight shear wave speed measurements using radiation force of a focused ultrasound beam. , 2011, Ultrasound in medicine & biology.

[72]  E. Cholongitas,et al.  Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy. , 2011, Journal of hepatology.

[73]  William M. Lee,et al.  Complication rate of percutaneous liver biopsies among persons with advanced chronic liver disease in the HALT-C trial. , 2010, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[74]  Ioan Sporea,et al.  Comparative study concerning the value of acoustic radiation force impulse elastography (ARFI) in comparison with transient elastography (TE) for the assessment of liver fibrosis in patients with chronic hepatitis B and C. , 2012, Ultrasound in medicine & biology.

[75]  P. Bedossa,et al.  Diagnostic accuracy of FibroScan and comparison to liver fibrosis biomarkers in chronic viral hepatitis: a multicenter prospective study (the FIBROSTIC study). , 2010, Journal of hepatology.

[76]  V. de Lédinghen,et al.  Pitfalls of liver stiffness measurement: A 5‐year prospective study of 13,369 examinations , 2010, Hepatology.

[77]  J. R. Doherty,et al.  Acoustic radiation force elasticity imaging in diagnostic ultrasound , 2013, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[78]  G. Casazza,et al.  Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis. , 2012, Gastroenterology.

[79]  Hui Zhu,et al.  Performance of magnetic resonance elastography and diffusion‐weighted imaging for the staging of hepatic fibrosis: A meta‐analysis , 2012, Hepatology.

[80]  Mickael Tanter,et al.  Ultrafast imaging in biomedical ultrasound , 2014, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control.

[81]  Jingfeng Jiang,et al.  Linear and Nonlinear Elastic Modulus Imaging: An Application to Breast Cancer Diagnosis , 2012, IEEE Transactions on Medical Imaging.

[82]  M. Lupsor,et al.  Performance of Acoustic Radiation Force Impulse imaging for the staging of liver fibrosis: a pooled meta‐analysis , 2012, Journal of viral hepatitis.

[83]  G. Ferraioli,et al.  Accuracy of real‐time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study , 2012, Hepatology.

[84]  B. Garra,et al.  AN OVERVIEW OF ELASTOGRAPHY - AN EMERGING BRANCH OF MEDICAL IMAGING. , 2011, Current medical imaging reviews.

[85]  Kevin J Parker,et al.  Physical models of tissue in shear fields. , 2014, Ultrasound in medicine & biology.

[86]  J. Rubin,et al.  A new nonlinear parameter in the developed strain-to-applied strain of the soft tissues and its application in ultrasound elasticity imaging. , 2012, Ultrasound in medicine & biology.

[87]  A. Burroughs,et al.  Noninvasive assessment of liver fibrosis: The clinical context and question are important , 2011, Hepatology.

[88]  John F. Flaherty,et al.  Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study , 2013, The Lancet.

[89]  R. Sacco,et al.  Transient elastography: a new surrogate marker of liver fibrosis influenced by major changes of transaminases , 2007, Journal of viral hepatitis.

[90]  R. Groszmann,et al.  American association for the study of liver diseases , 1992 .

[91]  K. Nightingale.  Acoustic Radiation Force Impulse (ARFI) Imaging: a Review. , 2011, Current medical imaging reviews.

[92]  H. Cortez‐Pinto,et al.  Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal. , 2013, Journal of hepatology.

[93]  R. Ehman,et al.  Magnetic resonance elastography of liver. , 2014, Magnetic resonance imaging clinics of North America.

[94]  J. Pawlotsky,et al.  Noninvasive diagnosis of liver fibrosis in patients with chronic hepatitis C. , 2005, MedGenMed : Medscape general medicine.

[95]  Eva Herrmann,et al.  Performance of transient elastography for the staging of liver fibrosis: a meta-analysis. , 2008, Gastroenterology.

[96]  Ralph Sinkus,et al.  Magnetic resonance elastography for the noninvasive staging of liver fibrosis. , 2008, Gastroenterology.

[97]  G. Ferraioli,et al.  Point shear wave elastography method for assessing liver stiffness. , 2014, World journal of gastroenterology.

[98]  G. Leandro,et al.  Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease. , 2003, Journal of hepatology.

[99]  Maggie Westby,et al.  Diagnosis and management of chronic hepatitis B in children, young people, and adults: summary of NICE guidance , 2013, BMJ.

[100]  Tsuyoshi Shiina,et al.  WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: basic principles and terminology. , 2015, Ultrasound in medicine & biology.

[101]  S. Friedman,et al.  Now there are many (stages) where before there was one: In search of a pathophysiological classification of cirrhosis , 2010, Hepatology.

[102]  Richard L Ehman,et al.  Cross‐validation of magnetic resonance elastography and ultrasound‐based transient elastography: A preliminary phantom study , 2009, Journal of magnetic resonance imaging : JMRI.

[103]  Mirko D'Onofrio,et al.  Tissue quantification with acoustic radiation force impulse imaging: Measurement repeatability and normal values in the healthy liver. , 2010, AJR. American journal of roentgenology.

[104]  X. Forns,et al.  Efficacy of antiviral therapy on hepatitis C recurrence after liver transplantation: a randomized controlled study. , 2007, Gastroenterology.

[105]  Z. Younossi,et al.  Epidemiology and natural history of NAFLD and NASH. , 2007, Clinics in liver disease.

[106]  Dieter Häussinger,et al.  Transient elastography is unreliable for detection of cirrhosis in patients with acute liver damage , 2007, Hepatology.

[107]  J. Feld,et al.  An update on the management of chronic hepatitis C: 2015 Consensus guidelines from the Canadian Association for the Study of the Liver. , 2012, Canadian journal of gastroenterology & hepatology.

[108]  K. Nouso,et al.  Measurement of spleen stiffness by acoustic radiation force impulse imaging identifies cirrhotic patients with esophageal varices. , 2013, Gastroenterology.

[109]  F. Oberti,et al.  Reproducibility of liver stiffness measurement by ultrasonographic elastometry. , 2008, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[110]  S. Mueller,et al.  Non-invasive diagnosis of alcoholic liver disease. , 2014, World journal of gastroenterology.

[111]  M. Attanasio,et al.  Comparison of Transient Elastography and Acoustic Radiation Force Impulse for Non-Invasive Staging of Liver Fibrosis in Patients With Chronic Hepatitis C , 2011, The American Journal of Gastroenterology.

[112]  A. Manduca,et al.  Magnetic resonance elastography by direct visualization of propagating acoustic strain waves. , 1995, Science.

[113]  Gunda Millonig,et al.  Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosis , 2008, Hepatology.

[114]  V. de Lédinghen,et al.  Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. , 2005, Gastroenterology.

[115]  T. Matsumura,et al.  Breast disease: clinical application of US elastography for diagnosis. , 2006, Radiology.

[116]  V. de Lédinghen,et al.  Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study , 2005, Gut.

[117]  M. Friedrich-Rust,et al.  Acoustic radiation force impulse-imaging and transient elastography for non-invasive assessment of liver fibrosis and steatosis in NAFLD. , 2012, European journal of radiology.