JSUM ultrasound elastography practice guidelines: liver.
In diffuse liver disease, it is extremely important to make an accurate diagnosis of liver fibrosis prior to determining indications for therapy or predicting treatment outcome and malignant potential. Although liver biopsy has long been the gold standard in the diagnosis of liver fibrosis, it is still an invasive method. In addition, the sampling error is an intrinsic problem of liver biopsy. Non-invasive serological methods for the diagnosis of liver fibrosis can be affected by factors unrelated to the liver. Recently, after the introduction of FibroScan, it became possible to measure liver fibrosis directly and non-invasively by elastography, which has attracted attention as a non-invasive imaging diagnostic tool for liver fibrosis. In addition, real-time tissue elastography is currently being used to conduct clinical trials at many institutions. Moreover, virtual touch quantification enables the observation of liver stiffness at any location by simply observing B-mode images. Furthermore, the recently developed ShearWave elastography visualizes liver stiffness on a color map. Elastography is thought to be useful for all types of diffuse liver diseases. Because of its association with portal hypertension and liver carcinogenesis, elastography is expected to function as a novel prognostic tool for liver disease. Although various elastographic devices have been developed by multiple companies, each device has its own measurement principle, method, and outcome, creating confusion in clinical settings. Therefore, it is extremely important to understand the characteristics of each device in advance. The objective of this guideline, which describes the characteristics of each device based on the latest knowledge, is for all users to be able to make the correct diagnosis of hepatic fibrosis by ultrasound elastography.
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan. m-kudo@med.kindai.ac.jp.
Masatoshi
M
Kudo
Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Tsuyoshi
T
Shiina
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Fuminori
F
Moriyasu
Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Hiroko
H
Iijima
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Ryosuke
R
Tateishi
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka, 589-8511, Japan.
Norihisa
N
Yada
Department of Internal Medicine, Nagayama Hospital, Kumatori, Osaka, Japan.|Division of Clinical Research, ONH Minamiwakayama Medical Center, Tanabe, Wakayama, Japan.
Kenji
K
Fujimoto
Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Hiroyasu
H
Morikawa
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Masashi
M
Hirooka
Division of Gastroenterology and Hepatology, Toho University Ohmori Medical Center, Tokyo, Japan.
Yasukiyo
Y
Sumino
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
Takashi
T
Kumada
Elasticity; Elastography; Liver fibrosis; Shear wave; Stiffness; Strain