Acoustic radiation force impulse liver stiffness measurement

Karlas, Thomas; Pfrepper, C; Troeltzsch, Michael; Keim, Volker

doi:10.1097/meg.0b013e32833caf8e

Cited by 7 publications

(2 citation statements)

References 2 publications

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“…Measurements should preferably be made intercostally in the right lobe, which has been shown to be more accurate than left lobe measurements [76,84]. Measurements should be acquired during shallow breath-holding or resting expiration to minimize liver motion, as deep inspiration increases stiffness measurements compared with resting expiratory position [85]. Figure 2A–B shows an example of liver fibrosis identified with ARFI which was not detectable with conventional grayscale US.…”

Section: Us Elastographymentioning

confidence: 99%

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

et al. 2017

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Hepatic fibrosis is potentially reversible, however early diagnosis is necessary for treatment in order to halt progression to cirrhosis and development of complications including portal hypertension and hepatocellular carcinoma. Morphologic signs of cirrhosis on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) alone are unreliable and are seen with more advanced disease. Newer imaging techniques to diagnose liver fibrosis are reliable and accurate, and include magnetic resonance elastography and US elastography (1 dimensional transient elastography and point shear wave elastography or acoustic radiation force impulse imaging). Research is ongoing with multiple other techniques for the noninvasive diagnosis of hepatic fibrosis, including MRI with diffusion weighted imaging, hepatobiliary contrast enhancement, and perfusion; CT using perfusion, fractional extracellular space techniques, and dual energy, contrast-enhanced US, texture analysis in multiple modalities, quantitative mapping, and direct molecular imaging probes. Efforts to advance the noninvasive imaging assessment of hepatic fibrosis will facilitate earlier diagnosis and improved patient monitoring with the goal of preventing the progression to cirrhosis and its complications.

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Section: Us Elastographymentioning

confidence: 99%

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

et al. 2017

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“…Deep inspiration has been shown to increase stiffness measurements compared with resting expiratory position [65]. Hence, breath-hold at expiration is preferable to obtain consistent liver position between acquisitions and to avoid overestimation of liver stiffness.…”

Section: Biologic Confoundersmentioning

confidence: 99%

Ultrasound Elastography and MR Elastography for Assessing Liver Fibrosis: Part 2, Diagnostic Performance, Confounders, and Future Directions

Tang

Cloutier

Szeverenyi

et al. 2015

American Journal of Roentgenology

171

112

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OBJECTIVE-The purpose of the article is to review the diagnostic performance of ultrasound and MR elastography techniques for detection and staging of liver fibrosis, the main current clinical applications of elastography in the abdomen.CONCLUSION-Technical and instrument-related factors and biologic and patient-related factors may constitute potential confounders of stiffness measurements for assessment of liver fibrosis. Future developments may expand the scope of elastography for monitoring liver fibrosis and predict complications of chronic liver disease. Keywords elasticity; elastography; liver fibrosis; MR elastography (MRE); MRI; ultrasound; viscosity In abdominal imaging, liver stiffness estimated by elastography techniques may be used as a quantitative imaging biomarker for detection, staging, and monitoring of liver fibrosis [1][2][3]. Liver stiffness is used to evaluate the severity of the underlying chronic liver disease, guide treatment decision, assess disease outcome, and evaluate response to therapy [4].In this second article of a two-part series [5], we will discuss the clinical applications in the liver. We will focus on diagnostic performance of ultrasound elastography and MR Address correspondence to C. B. Sirlin (csirlin@ucsd.edu).. Technologies developed by the team of G. Cloutier were licensed to Rheolution, Inc., and Acist Medical Systems. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript elastography techniques for detection, staging, and monitoring of liver fibrosis, the main current clinical applications of elastography in the abdomen. We will discuss potential confounders of stiffness measurements for assessment of liver fibrosis, which include technical and instrument-related factors (location and depth of measurements, wave frequencies, and device dependencies) and biologic and patient-related factors (concomitant hepatic steatosis, inflammation, cholestasis; breathing; right heart failure and hepatic venous congestion; and fasting vs postprandial state). Finally, we will briefly discuss future directions and technical innovations in this field of research.As will be shown in this article, elastography techniques integrated to clinical ultrasound and MR systems now provide the capability to examine by imaging what once could be examined only by direct palpation, which is likely to open new opportunities to noninvasively diagnose disease, guide management, and improve outcomes. Key Learning PointsFirst, the main current clinical indications for abdominal elastography techniques are detection and staging of liver fibrosis. In general, elastography techniques provide good-toexcellent diagnostic accuracy for the detection of advanced fibrosis but have more modest performance for detection of early or mild fibrosis. Most studies to date have been in adults; performance characteristics in children are less well known. Research is needed to better understand the performance of elastography for monitoring longitudinal changes in fibrosis. Emerg...

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