Vibration-controlled transient elastography: a practical approach to the noninvasive assessment of liver fibrosis.
OBJECTIVE
Therapeutic advances for hepatitis C and the increasing prevalence on nonalcoholic fatty liver disease are reshaping the diagnostic approach to disease staging in clinical hepatology. Well tolerated, inexpensive and reliable alternatives to liver biopsy are a critical need for clinicians and patients alike.


RESULTS
Vibration-controlled transient elastography (VCTE, also known as 'transient elastography') is a robust, point-of-care tool for the noninvasive assessment of liver fibrosis. This tool efficiently prioritizes the treatment for patients with viral hepatitis at risk for advanced liver disease and identifies the subgroups with metabolic or cholestatic liver disease who are at the highest risk. Rather than staging fibrosis, VCTE provides an accurate risk estimate of advanced fibrosis. In addition, it is increasingly recognized that elastography can predict outcomes including hepatic decompensation and mortality. The ideal use of this tool is to perform it in conjunction with a serologic marker of fibrosis to confirm its findings.


CONCLUSIONS
When combined with serologic markers of fibrosis, VCTE allows the vast majority of patients to avoid a liver biopsy.
Department of Medicine, Liver Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Elliot B
EB
Tapper
Nezam H
NH
Afdhal
D015415:Biomarkers; D018450:Disease Progression; D054459:Elasticity Imaging Techniques / Q000379:methods; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014732:Vibration
D015415:Biomarkers