Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Babu, Aparna Srinivasa; Wells, Michael; Teytelboym, Oleg M.; Mackey, Justin; Miller, Frank H.; Yeh, Benjamin M.; Ehman, Richard L.; Venkatesh, Sudhakar K.

doi:10.1148/rg.2016160042

Cited by 169 publications

(115 citation statements)

References 79 publications

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“…Future research needs in the fields of US elastography and MR elastography of the liver involve monitoring hepatic fibrosis after treatment, prognostication of hepatic complications including decompensation of cirrhosis and development of HCC, subclassification of patients with cirrhosis, detection of inflammation since fibrosis and inflammation can both contribute to increased liver stiffness, and predicting portal hypertension, including spleen stiffness [65,190]. Technical areas of research interest in US and MR elastography include 3D measurement of tissue displacement, multifrequency elastography, standardization of terminology, calibration of elastography measurements, and harmonization of the different elastography techniques [65].…”

Section: Future Research Needsmentioning

confidence: 99%

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

et al. 2017

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Hepatic fibrosis is potentially reversible, however early diagnosis is necessary for treatment in order to halt progression to cirrhosis and development of complications including portal hypertension and hepatocellular carcinoma. Morphologic signs of cirrhosis on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) alone are unreliable and are seen with more advanced disease. Newer imaging techniques to diagnose liver fibrosis are reliable and accurate, and include magnetic resonance elastography and US elastography (1 dimensional transient elastography and point shear wave elastography or acoustic radiation force impulse imaging). Research is ongoing with multiple other techniques for the noninvasive diagnosis of hepatic fibrosis, including MRI with diffusion weighted imaging, hepatobiliary contrast enhancement, and perfusion; CT using perfusion, fractional extracellular space techniques, and dual energy, contrast-enhanced US, texture analysis in multiple modalities, quantitative mapping, and direct molecular imaging probes. Efforts to advance the noninvasive imaging assessment of hepatic fibrosis will facilitate earlier diagnosis and improved patient monitoring with the goal of preventing the progression to cirrhosis and its complications.

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Section: Future Research Needsmentioning

confidence: 99%

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

et al. 2017

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“…

IntroductionOne of the major successes of elastography is the demonstrated ability to characterize high grade liver fibrosis by elevated shear wave speed estimates (Cosgrove et al 2013, Srinivasa Babu et al 2016. What remains unclear are the biomechanics of earlier stages of the progression of liver disease.

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confidence: 99%

The biomechanics of simple steatosis and steatohepatitis

et al. 2018

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Magnetic resonance and ultrasound elastography techniques are now important tools for staging high-grade fibrosis in patients with chronic liver disease. However, uncertainty remains about the effects of simple accumulation of fat (steatosis) and inflammation (steatohepatitis) on the parameters that can be measured using different elastographic techniques. To address this, we examine the rheological models that are capable of capturing the dominant viscoelastic behaviors associated with fat and inflammation in the liver, and quantify the resulting changes in shear wave speed and viscoelastic parameters. Theoretical results are shown to match measurements in phantoms and animal studies reported in the literature. These results are useful for better design of elastographic studies of fatty liver disease and steatohepatitis, potentially leading to improved diagnosis of these conditions.

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“…Furthermore, Poynard et al found that SWE had significantly higher applicability than TE when diagnosing liver fibrosis in the more progressive stages of fibrosis. Disadvantages to SWE are lack of diagnostic threshold standardization across manufacturers in addition to the imaging being operator dependent …”

Section: Discussionmentioning

confidence: 99%

FibroSURE and elastography poorly predict the severity of liver fibrosis in Fontan‐associated liver disease

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Horton

et al. 2018

Congenital Heart Disease

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This study demonstrates that children who have undergone a Fontan procedure universally develop some hepatic fibrosis and a significant number have advanced fibrosis by adulthood. The FibroSURE blood test, SWE, and hepatic duplex sonography were unable to accurately predict the presence or severity of hepatic fibrosis when compared with liver biopsy. Further studies are needed to investigate novel noninvasive methods and/or biomarkers that can adequately detect advanced hepatic fibrosis before the development of cirrhosis and hepatic decompensation.

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Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Cited by 169 publications

References 79 publications

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

The biomechanics of simple steatosis and steatohepatitis

FibroSURE and elastography poorly predict the severity of liver fibrosis in Fontan‐associated liver disease

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