title: Real-time elastography in the assessment of liver fibrosis: a review of qualitative and semi-quantitative methods for elastogram analysis.
abstract: Despite its invasiveness, liver biopsy is still considered the gold standard for the assessment of hepatic fibrosis. Non-invasive ultrasound-based techniques are increasingly employed to assess parenchymal stiffness and the progression of chronic diffuse liver diseases. Real-time elastography is a rapidly evolving technique that can reveal the elastic properties of tissues. This review examines qualitative and semi-quantitative methods developed for analysis of real-time liver elastograms, to estimate parenchymal stiffness and, indirectly, the stage of fibrosis. Qualitative analysis is the most immediate approach for elastogram analysis, but this method increases intra- and inter-observer variability, which is seen as a major limitation of real-time elastography. Semi-quantitative methods include analysis of the histogram derived from color-coded maps, as well as calculation of the elastic ratio and fibrosis index.
authors: Department of Radiology, E. O. Ospedali Galliera, Genoa, Italy. Electronic address: Francesco.paparo@galliera.it.
authors: Francesco
authors: F
authors: Paparo
authors: Anaesthesia and Intensive Care Unit, E. O. Ospedali Galliera, Genoa, Italy.
authors: Francesco
authors: F
authors: Corradi
authors: School of Radiology, University of Genoa, Genoa, Italy.
authors: Luca
authors: L
authors: Cevasco
authors: School of Radiology, University of Genoa, Genoa, Italy.
authors: Matteo
authors: M
authors: Revelli
authors: Department of Radiology, E. O. Ospedali Galliera, Genoa, Italy.
authors: Andrea
authors: A
authors: Marziano
authors: Department of Radiology, E. O. Ospedali Galliera, Genoa, Italy.
authors: Lucio
authors: L
authors: Molini
authors: Unit of Infectious Diseases, E. O. Ospedali Galliera, Genoa, Italy.
authors: Giovanni
authors: G
authors: Cenderello
authors: Unit of Infectious Diseases, E. O. Ospedali Galliera, Genoa, Italy.
authors: Giovanni
authors: G
authors: Cassola
authors: Department of Radiology, E. O. Ospedali Galliera, Genoa, Italy.
authors: Gian Andrea
authors: GA
authors: Rollandi
mesh_terms: D003199:Computer Systems; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Elastic ratio; Fibrosis index; Liver fibrosis; Real-time elastography