Reproducibility of Liver Stiffness Measurement by Ultrasonographic Elastometry

Non‐invasive diagnosis tests

“…Although TE analysis has excellent inter-and intraobserver agreement [39,57], its applicability (80%) is not as good as that of serum biomarkers. Failure to obtain any measurement has been reported in 3% of cases and unreliable results (not meeting manufacturer's recommendations) have been reported for 16% [58], mostly resulting from patient obesity or limited operator experience.…”

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“…The agreement decreases in overweight patients or in early stages of fibrosis [94,95]. Although the LSM seems to be reproducible at different examination sites, the best examination site is the median axillary line on the first intercostal space under the liver percussion dullness upper limit, with the patient lying in dorsal decubitus [95].…”

Romanian national guidelines and practical recommendations on liver elastography

“…Reproducibility Published studies proved that TE is a highly reproducible method, with interobserver and intraobserver intraclass coefficient correlation ranging from 0.93 to 0.96 [9,[18][19][20], with a very short learning curve -50 examinations being required in order to obtain reliable measurements [21,22]. The study performed by Boursier et al also showed a high measurement agreement between novices and expert operators, even during the first 10 cases [22], so that a formal session by a qualified trainer, followed by practice on 50 cases, should suffice for the training of most operators.…”

“…follow-up of the vibration propagation are automatically rejected by the software. Measurements should be made in fasting conditions (since food intake increases LS values) [7,8], while the patient is holding breath to minimize errors [9].…”