Skip to main content
Top
Published in: Abdominal Radiology 11/2020

Open Access 01-11-2020 | Ultrasound | Review Paper: Diffuse Liver Disease

Ultrasound-based liver elastography: current results and future perspectives

Authors: Cheng Fang, Paul S. Sidhu

Published in: Abdominal Radiology | Issue 11/2020

Login to get access

Abstract

Chronic liver disease affects 185 million population worldwide. It encompasses a heterogenous disease spectrum, but all can lead to the development of liver fibrosis. The degree of liver fibrosis is not only a prognosticator, but has also been used to guide the treatment strategy and to evaluate treatment response. Traditionally, staging of liver fibrosis is determined on histological analysis using samples obtained from an invasive liver biopsy. Ultrasound-based liver elastography is a non-invasive method of assessing diffuse liver disease in patients with known chronic liver disease. The use of liver elastography has led to a significant reduction in the number of liver biopsies performed to assess the severity of liver fibrosis and a liver biopsy is now reserved for only select sub-groups of patients. The aim of this review article is to discuss the key findings and current evidence for ultrasound-based elastography in diffuse liver disease as well as the technical challenges and to evaluate the potential research direction.
Literature
2.
go back to reference Cosgrove D, Piscaglia F, Bamber J, et al (2013) EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography. Part 2: Clinical Applications. Ultraschall in der Medizin - European Journal of Ultrasound 34:238–253. https://doi.org/10.1055/s-0033-1335375 Cosgrove D, Piscaglia F, Bamber J, et al (2013) EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography. Part 2: Clinical Applications. Ultraschall in der Medizin - European Journal of Ultrasound 34:238–253. https://​doi.​org/​10.​1055/​s-0033-1335375
4.
go back to reference Ferraioli G, Wong VW-S, Castera L, et al (2018) Liver Ultrasound Elastography: An Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations. Ultrasound in Medicine & Biology. 10.1016/j.ultrasmedbio.2018.07.008 Ferraioli G, Wong VW-S, Castera L, et al (2018) Liver Ultrasound Elastography: An Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations. Ultrasound in Medicine & Biology. 10.1016/j.ultrasmedbio.2018.07.008
5.
go back to reference Barr RG, Ferraioli G, Palmeri ML, et al (2016) Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement. Ultrasound Q 32:94–107. 0.1097/RUQ.0000000000000209 Barr RG, Ferraioli G, Palmeri ML, et al (2016) Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement. Ultrasound Q 32:94–107. 0.1097/RUQ.0000000000000209
6.
go back to reference Cosgrove D, Piscaglia F, Bamber J, et al (2013) EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography.Part 2: Clinical Applications. Ultraschall in der Medizin - European Journal of Ultrasound 34:238–253. https://doi.org/10.1055/s-0033-1335375 Cosgrove D, Piscaglia F, Bamber J, et al (2013) EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography.Part 2: Clinical Applications. Ultraschall in der Medizin - European Journal of Ultrasound 34:238–253. https://​doi.​org/​10.​1055/​s-0033-1335375
8.
13.
go back to reference Fang C, Lim A, Sidhu PS (2020) Ultrasound-based liver elastography in the assessment of fibrosis. Clin Radiol. 10.1016/j.crad.2020.01.005 Fang C, Lim A, Sidhu PS (2020) Ultrasound-based liver elastography in the assessment of fibrosis. Clin Radiol. 10.1016/j.crad.2020.01.005
14.
go back to reference Dietrich C, Bamber J, Berzigotti A, et al (2017) EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version). Ultraschall in der Medizin - European Journal of Ultrasound. 10.1055/s-0043-103952 Dietrich C, Bamber J, Berzigotti A, et al (2017) EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version). Ultraschall in der Medizin - European Journal of Ultrasound. 10.1055/s-0043-103952
15.
go back to reference Fang C, Jaffer OS, Yusuf GT, et al (2018) Reducing the Number of Measurements in Liver Point Shear-Wave Elastography: Factors that Influence the Number and Reliability of Measurements in Assessment of Liver Fibrosis in Clinical Practice. Radiology 172104. https://doi.org/10.1148/radiol.2018172104 Fang C, Jaffer OS, Yusuf GT, et al (2018) Reducing the Number of Measurements in Liver Point Shear-Wave Elastography: Factors that Influence the Number and Reliability of Measurements in Assessment of Liver Fibrosis in Clinical Practice. Radiology 172104. https://​doi.​org/​10.​1148/​radiol.​2018172104
16.
go back to reference Sporea I, Grădinaru-Taşcău O, Bota S, et al (2013) How many measurements are needed for liver stiffness assessment by 2D-Shear Wave Elastography (2D-SWE) and which value should be used: the mean or median? Med Ultrason 15:268–272 Sporea I, Grădinaru-Taşcău O, Bota S, et al (2013) How many measurements are needed for liver stiffness assessment by 2D-Shear Wave Elastography (2D-SWE) and which value should be used: the mean or median? Med Ultrason 15:268–272
18.
go back to reference Ferraioli G, Maiocchi L, Lissandrin R, et al (2016) Accuracy of the ElastPQ Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study. J Gastrointestin Liver Dis 25:331–335 Ferraioli G, Maiocchi L, Lissandrin R, et al (2016) Accuracy of the ElastPQ Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study. J Gastrointestin Liver Dis 25:331–335
20.
go back to reference Bota S, Sporea I, Sirli R, et al (2011) Factors that influence the correlation of acoustic radiation force impulse (ARFI) elastography with liver fibrosis. Medical ultrasonography 13:135 Bota S, Sporea I, Sirli R, et al (2011) Factors that influence the correlation of acoustic radiation force impulse (ARFI) elastography with liver fibrosis. Medical ultrasonography 13:135
21.
go back to reference Ferraioli G, De Silvestri A, Lissandrin R, et al (2018) Evaluation of Inter-System Variability in Liver Stiffness Measurements. Ultraschall in der Medizin - European Journal of Ultrasound. 10.1055/s-0043-124184 Ferraioli G, De Silvestri A, Lissandrin R, et al (2018) Evaluation of Inter-System Variability in Liver Stiffness Measurements. Ultraschall in der Medizin - European Journal of Ultrasound. 10.1055/s-0043-124184
24.
go back to reference Jeong WK (2015) Liver stiffness measurement using S-Shearwave: initial experience. White Paper, CS201505-S-Shearwave, Samsung Medison Jeong WK (2015) Liver stiffness measurement using S-Shearwave: initial experience. White Paper, CS201505-S-Shearwave, Samsung Medison
26.
go back to reference Sirli R, Sporea I, Tudora A, et al (2009) Transient elastographic evaluation of subjects without known hepatic pathology: does age change the liver stiffness. J Gastrointestin Liver Dis 18:57–60 Sirli R, Sporea I, Tudora A, et al (2009) Transient elastographic evaluation of subjects without known hepatic pathology: does age change the liver stiffness. J Gastrointestin Liver Dis 18:57–60
29.
go back to reference Das Kausik, Sarkar Rajib, Ahmed Sk. Mahiuddin, et al (2011) “Normal” liver stiffness measure (LSM) values are higher in both lean and obese individuals: A population‐based study from a developing country. Hepatology 55:584–593. https://doi.org/10.1002/hep.24694 Das Kausik, Sarkar Rajib, Ahmed Sk. Mahiuddin, et al (2011) “Normal” liver stiffness measure (LSM) values are higher in both lean and obese individuals: A population‐based study from a developing country. Hepatology 55:584–593. https://​doi.​org/​10.​1002/​hep.​24694
39.
go back to reference Sporea I, Bota S, Grădinaru-Taşcău O, et al (2014) Comparative study between two point Shear Wave Elastographic techniques: Acoustic Radiation Force Impulse (ARFI) elastography and ElastPQ. Med Ultrason 16:309–314 Sporea I, Bota S, Grădinaru-Taşcău O, et al (2014) Comparative study between two point Shear Wave Elastographic techniques: Acoustic Radiation Force Impulse (ARFI) elastography and ElastPQ. Med Ultrason 16:309–314
41.
go back to reference Yoon JH, Lee JM, Han JK, Cho BI (2014) Shear Wave Elastography for Liver Stiffness Measurement in Clinical Sonographic Examinations: Evaluation of Intraobserver Reproducibility, Technical Failure, and Unreliable Stiffness Measurements. Journal of Ultrasound in Medicine 33:437–447. https://doi.org/10.7863/ultra.33.3.437 Yoon JH, Lee JM, Han JK, Cho BI (2014) Shear Wave Elastography for Liver Stiffness Measurement in Clinical Sonographic Examinations: Evaluation of Intraobserver Reproducibility, Technical Failure, and Unreliable Stiffness Measurements. Journal of Ultrasound in Medicine 33:437–447. https://​doi.​org/​10.​7863/​ultra.​33.​3.​437
43.
go back to reference Arda K, Ciledag N, Arıbas BK, et al (2013) Quantitative assessment of the elasticity values of liver with shear wave ultrasonographic elastography. Indian J Med Res 137:911–915 Arda K, Ciledag N, Arıbas BK, et al (2013) Quantitative assessment of the elasticity values of liver with shear wave ultrasonographic elastography. Indian J Med Res 137:911–915
45.
go back to reference Leung VY, Shen J, Wong VW, et al (2013) Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: comparison of shear-wave elastography and transient elastography with liver biopsy correlation. Radiology 269:910–918 Leung VY, Shen J, Wong VW, et al (2013) Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: comparison of shear-wave elastography and transient elastography with liver biopsy correlation. Radiology 269:910–918
48.
go back to reference Goertz RS, Egger C, Neurath MF, Strobel D (2012) Impact of food intake, ultrasound transducer, breathing maneuvers and body position on acoustic radiation force impulse (ARFI) elastometry of the liver. Ultraschall Med 33:380–385. https://doi.org/10.1055/s-0032-1312816 Goertz RS, Egger C, Neurath MF, Strobel D (2012) Impact of food intake, ultrasound transducer, breathing maneuvers and body position on acoustic radiation force impulse (ARFI) elastometry of the liver. Ultraschall Med 33:380–385. https://​doi.​org/​10.​1055/​s-0032-1312816
51.
go back to reference Jaffer OS, Lung PFC, Bosanac D, et al (2012) Acoustic radiation force impulse quantification: repeatability of measurements in selected liver segments and influence of age, body mass index and liver capsule-to-box distance. Br J Radiol 85:e858-863. https://doi.org/10.1259/bjr/74797353 Jaffer OS, Lung PFC, Bosanac D, et al (2012) Acoustic radiation force impulse quantification: repeatability of measurements in selected liver segments and influence of age, body mass index and liver capsule-to-box distance. Br J Radiol 85:e858-863. https://​doi.​org/​10.​1259/​bjr/​74797353
52.
go back to reference Fang C, Konstantatou E, Romanos O, et al (2017) Reproducibility of 2-Dimensional Shear Wave Elastography Assessment of the Liver: A Direct Comparison With Point Shear Wave Elastography in Healthy Volunteers. J Ultrasound Med. 10.7863/ultra.16.07018 Fang C, Konstantatou E, Romanos O, et al (2017) Reproducibility of 2-Dimensional Shear Wave Elastography Assessment of the Liver: A Direct Comparison With Point Shear Wave Elastography in Healthy Volunteers. J Ultrasound Med. 10.7863/ultra.16.07018
56.
go back to reference Piccinino F, Sagnelli E, Pasquale G, Giusti G (1986) Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. J Hepatol 2:165–173 Piccinino F, Sagnelli E, Pasquale G, Giusti G (1986) Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. J Hepatol 2:165–173
57.
go back to reference McGill DB, Rakela J, Zinsmeister AR, Ott BJ (1990) A 21-year experience with major hemorrhage after percutaneous liver biopsy. Gastroenterology 99:1396–1400 McGill DB, Rakela J, Zinsmeister AR, Ott BJ (1990) A 21-year experience with major hemorrhage after percutaneous liver biopsy. Gastroenterology 99:1396–1400
64.
go back to reference Li Y, Huang Y-S, Wang Z-Z, et al (2016) Systematic review with meta-analysis: the diagnostic accuracy of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B. Aliment Pharmacol Ther 43:458–469. https://doi.org/10.1111/apt.13488 Li Y, Huang Y-S, Wang Z-Z, et al (2016) Systematic review with meta-analysis: the diagnostic accuracy of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B. Aliment Pharmacol Ther 43:458–469. https://​doi.​org/​10.​1111/​apt.​13488
65.
go back to reference Hu X, Qiu L, Liu D, Qian L (2017) Acoustic Radiation Force Impulse (ARFI) Elastography for non‑invasive evaluation of hepatic fibrosis in chronic hepatitis B and C patients: a systematic review and meta-analysis. Med Ultrason 19:23–31 Hu X, Qiu L, Liu D, Qian L (2017) Acoustic Radiation Force Impulse (ARFI) Elastography for non‑invasive evaluation of hepatic fibrosis in chronic hepatitis B and C patients: a systematic review and meta-analysis. Med Ultrason 19:23–31
68.
69.
go back to reference Herrmann E, de Lédinghen V, Cassinotto C, et al (2018) Assessment of biopsy‐proven liver fibrosis by two‐dimensional shear wave elastography: An individual patient data‐based meta‐analysis. Hepatology 67:260–272. https://doi.org/10.1002/hep.29179 Herrmann E, de Lédinghen V, Cassinotto C, et al (2018) Assessment of biopsy‐proven liver fibrosis by two‐dimensional shear wave elastography: An individual patient data‐based meta‐analysis. Hepatology 67:260–272. https://​doi.​org/​10.​1002/​hep.​29179
71.
go back to reference Foncea CG, Popescu A, Lupusoru R, et al (2020) Comparative study between pSWE and 2D-SWE techniques integrated in the same ultrasound machine, with Transient Elastography as the reference method. Med Ultrason 22:13–19. https://doi.org/10.11152/mu-2179 Foncea CG, Popescu A, Lupusoru R, et al (2020) Comparative study between pSWE and 2D-SWE techniques integrated in the same ultrasound machine, with Transient Elastography as the reference method. Med Ultrason 22:13–19. https://​doi.​org/​10.​11152/​mu-2179
72.
go back to reference Schellhaas B, Strobel D, Wildner D, et al (2017) Two-dimensional shear-wave elastography: a new method comparable to acoustic radiation force impulse imaging? Eur J Gastroenterol Hepatol. 10.1097/MEG.0000000000000846 Schellhaas B, Strobel D, Wildner D, et al (2017) Two-dimensional shear-wave elastography: a new method comparable to acoustic radiation force impulse imaging? Eur J Gastroenterol Hepatol. 10.1097/MEG.0000000000000846
75.
go back to reference Hall TJ, Milkowski A, Garra B, et al (2013) RSNA/QIBA: Shear wave speed as a biomarker for liver fibrosis staging. In: Ultrasonics Symposium (IUS), 2013 IEEE International. IEEE, pp 397–400 Hall TJ, Milkowski A, Garra B, et al (2013) RSNA/QIBA: Shear wave speed as a biomarker for liver fibrosis staging. In: Ultrasonics Symposium (IUS), 2013 IEEE International. IEEE, pp 397–400
76.
go back to reference Dillman JR, Chen S, Davenport MS, et al (2015) Superficial Ultrasound Shear Wave Speed Measurements in Soft and Hard Elasticity Phantoms: Repeatability and Reproducibility Using Two Different Ultrasound Systems. Pediatr Radiol 45:376–385. https://doi.org/10.1007/s00247-014-3150-6 Dillman JR, Chen S, Davenport MS, et al (2015) Superficial Ultrasound Shear Wave Speed Measurements in Soft and Hard Elasticity Phantoms: Repeatability and Reproducibility Using Two Different Ultrasound Systems. Pediatr Radiol 45:376–385. https://​doi.​org/​10.​1007/​s00247-014-3150-6
80.
go back to reference Knop V, Hoppe D, Welzel T, et al (2016) Regression of fibrosis and portal hypertension in HCV-associated cirrhosis and sustained virologic response after interferon-free antiviral therapy. J Viral Hepat 23:994–1002. https://doi.org/10.1111/jvh.12578 Knop V, Hoppe D, Welzel T, et al (2016) Regression of fibrosis and portal hypertension in HCV-associated cirrhosis and sustained virologic response after interferon-free antiviral therapy. J Viral Hepat 23:994–1002. https://​doi.​org/​10.​1111/​jvh.​12578
87.
go back to reference Xiao G, Zhu S, Xiao X, et al (2017) Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis. Hepatology 66:1486–1501. https://doi.org/10.1002/hep.29302 Xiao G, Zhu S, Xiao X, et al (2017) Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis. Hepatology 66:1486–1501. https://​doi.​org/​10.​1002/​hep.​29302
105.
106.
go back to reference Gatos I, Tsantis S, Spiliopoulos S, et al (2019) Temporal stability assessment in shear wave elasticity images validated by deep learning neural network for chronic liver disease fibrosis stage assessment. Med Phys 46:2298–2309. https://doi.org/10.1002/mp.13521 Gatos I, Tsantis S, Spiliopoulos S, et al (2019) Temporal stability assessment in shear wave elasticity images validated by deep learning neural network for chronic liver disease fibrosis stage assessment. Med Phys 46:2298–2309. https://​doi.​org/​10.​1002/​mp.​13521
Metadata
Title
Ultrasound-based liver elastography: current results and future perspectives
Authors
Cheng Fang
Paul S. Sidhu
Publication date
01-11-2020
Publisher
Springer US
Published in
Abdominal Radiology / Issue 11/2020
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02717-x

Other articles of this Issue 11/2020

Abdominal Radiology 11/2020 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.