Critical comparison of elastography methods to assess chronic liver disease.
Staging of liver fibrosis and diagnosis, or exclusion, of early compensated liver cirrhosis are important in the treatment decisions and surveillance of patients with chronic liver disease. Good diagnostic accuracy, increased availability and the possibility to perform follow-up examinations led to the implementation of noninvasive methods into clinical practice. Noninvasive tests are increasingly included in national and international guidelines, leaving liver biopsy reserved for patients with unexplained discordance or suspected additional aetiologies of liver disease. In addition to staging of liver fibrosis, data on the prognostic value of these methods have increased in the past few years and are of great importance for patient care. This Review focuses on elastography methods for noninvasive assessment of liver fibrosis, disease severity and prognosis. Although liver elastography started with transient elastography, at present all large ultrasonography companies offer an elastography technique integrated in their machines. The goal of this Review is to summarize the methodological problems of noninvasive tests in general, in addition to providing an overview on currently available techniques and latest developments in liver elastography.
Department of Internal Medicine, J.W. Goethe-University Hospital, Theodor-Stern-Kai 7, Frankfurt 60590, Germany.
Mireen
M
Friedrich-Rust
Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Hepatology Department, 47-83 Boulevard de l'Hôpital, Paris 75013, France.|Université Pierre et Marie Curie, INSERM, UMR-S 938, 57 Boulevard de l'Hôpital, Paris 75013, France.
Thierry
T
Poynard
Department of Hepatology, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, 100 Boulevard du General Leclerc, Clichy 92110, France.|Université Paris VII, INSERM UMR 1149, Centre de Recherche sur l'Inflammation, 16 Rue Huchard, Paris 75018, France.
Laurent
L
Castera
D000465:Algorithms; D002908:Chronic Disease; D054459:Elasticity Imaging Techniques / Q000379:methods* / Q000592:standards; D004932:Esophageal and Gastric Varices / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012680:Sensitivity and Specificity; D013154:Spleen / Q000502:physiology