title: Clinical applications, limitations and future role of transient elastography in the management of liver disease.
abstract: Transient elastography (TE) is a reliable tool for the non-invasive assessment of liver fibrosis in routine clinical practice. TE is currently approved for use in Europe, Asia and the United States. The widespread adoption of this technology is certain to increase the use of TE worldwide. Although TE has been well validated in chronic viral hepatitis, its clinical role in other liver diseases remains less clear. The advent of new treatment for chronic hepatitis C and emerging prevalence of non-alcoholic steatohepatitis raises new questions on the role of TE in current clinical practice. This review aims to examine the clinical applications, limitations and future role of TE in current clinical practice in light of the changing epidemiology of liver diseases and new clinical management paradigms. In current clinical practice, TE is the most accurate non-invasive method for diagnosis of liver cirrhosis. TE is useful to rule out fibrosis and cirrhosis but does not have sufficient accuracy to discern between various stages of fibrosis. The clinical role of TE has evolved from cross-sectional point-in-time assessment of fibrosis and cirrhosis to the more relevant role of prediction of vital clinical end-points. This provides clinicians with the ability to modify treatment strategies based on the information provided by TE. TE has evolved over the past decade to become an essential tool to assist the clinician in the management of chronic liver disease.
authors: Pik Eu Chang, George Boon-Bee Goh, Jing Hieng Ngu, Hiang Keat Tan, Chee Kiat Tan, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169586, Singapore.
authors: Pik Eu
authors: PE
authors: Chang
authors: Pik Eu Chang, George Boon-Bee Goh, Jing Hieng Ngu, Hiang Keat Tan, Chee Kiat Tan, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169586, Singapore.
authors: George Boon-Bee
authors: GB
authors: Goh
authors: Pik Eu Chang, George Boon-Bee Goh, Jing Hieng Ngu, Hiang Keat Tan, Chee Kiat Tan, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169586, Singapore.
authors: Jing Hieng
authors: JH
authors: Ngu
authors: Pik Eu Chang, George Boon-Bee Goh, Jing Hieng Ngu, Hiang Keat Tan, Chee Kiat Tan, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169586, Singapore.
authors: Hiang Keat
authors: HK
authors: Tan
authors: Pik Eu Chang, George Boon-Bee Goh, Jing Hieng Ngu, Hiang Keat Tan, Chee Kiat Tan, Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169586, Singapore.
authors: Chee Kiat
authors: CK
authors: Tan
keywords: Chronic; Fibrosis; Liver stiffness; Non-invasive; Transient elastography