Feasibility of transient elastography versus real-time two-dimensional shear wave elastography in difficult-to-scan patients

Abstract

Transient elastography can be accomplished in nearly all patients by use of the FibroScan XL probe and repeated examinations. In difficult-to-scan patients, the feasibility of TE is superior to 2D-SWE.

Accuracy of the Enhanced Liver Fibrosis Test vs FibroTest, Elastography, and Indirect Markers in Detection of Advanced Fibrosis in Patients With Alcoholic Liver Disease

“…This finding also highlights measurement failures as a central disadvantage of ultrasound elastography and will hopefully motivate clinicians to push for obtaining reliable TE results, even in patients who fail at the first attempt. 43 A key advantage of our study is the inclusion of a large cohort of patients recruited from primary care, which strengthens the generalizability of our results. Additionally, we did not exclude patients with markers of the metabolic syndrome or ongoing drinking, which also reflects real-life patients.…”

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

“…Failuremost often defined as the "inability to obtain an adequate signal for all acquisitions"occur in up to 10 % of cases reported in the published series. Common causes of failure are: depth below 4 -5 cm [26], poor ultrasound window, reverberations, pulsatile movement, poor breath hold, large amounts of ascites [117], intercostal wall thickness ≥ 25 mm [119], BMI ≥ 30 kg/m 2 , histological steatosis and waist circumference ≥ 102 cm [57,59].…”

Pitfalls and sources of variability in two dimensional shear wave elastography of the liver: An overview

“…As described earlier, 2D liver SWE performs optimally at a 4–5 cm deep to the transducer but can image up to 7cm . As a result, high body mass index (BMI) patients have been shown to be a limiting factor, with the rate of successful 2D SWE acquisitions decreasing with increasing BMI .…”