EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version)

Dietrich, Christoph F.; Bamber, Jeffrey C.; Berzigotti, Annalisa; Bota, Simona; Cantisani, Vito; Castéra, Laurent; Cosgrove, David O.; Ferraioli, Giovanna; Friedrich‐Rust, Mireen; Gilja, Odd Helge; Goertz, Ruediger S.; Karlas, Thomas; Knegt, RJ de; Lédinghen, Victor de; Piscaglia, Fabio; Procopeţ, Bogdan; Săftoiu, Adrian; Sidhu, Paul S.; Sporea, Ioan; Thiele, Maja

doi:10.1055/a-0641-0076

Cited by 151 publications

(153 citation statements)

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“…Ultrasound elastography is a useful non-invasive tool for the diagnosis of liver fibrosis in adults [1][2][3][4][5][6][7]. It plays a similar role in children, with some differences in the confounding factors and in the etiological spectrum of the liver disease; however, guidelines and recommendations have not been published yet.…”

Section: Introductionmentioning

confidence: 99%

Current Knowledge in Ultrasound-Based Liver Elastography of Pediatric Patients

et al. 2018

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Featured Application: In this review we present and discuss the published literature on the use of ultrasound-based liver elastography in children. The published data show that all the available shear wave elastography techniques are feasible and accurate for the assessment of liver fibrosis in children with diffuse liver disease due to several etiologies. For the assessment of focal liver lesions evidences are limited and no conclusion can be drawn so far.Abstract: Studies performed using transient elastography (TE), point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) have shown that these techniques are all feasible and accurate in children for the evaluation of liver fibrosis due to several etiologies. However, for some specific pediatric pathologies, such as biliary atresia, the evidence is still limited. As shown in adults, inflammation is a confounding factor when assessing fibrosis severity and care should be taken when interpreting the results. Due to the scarce comparative data between serological tests and elastography techniques in children, a definite conclusion regarding which is the best cannot be drawn. Neither non-invasive elastographic techniques nor laboratory scores allow determination of the presence and the degree of inflammation, necrosis, iron or copper deposits.

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Section: Introductionmentioning

confidence: 99%

Current Knowledge in Ultrasound-Based Liver Elastography of Pediatric Patients

et al. 2018

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“…statistical difference between the median value of all five measurements and the 2D SWE value of the first measurement as well as in comparison with the median 2D SWE value of the first three and five measurements. We are far from suggesting that only one measurement is reliable and we agree with the statement that at least three 2D SWE measurements should be performed (13,14). Only one measurement probably could be sufficient as the screen-6 Hepat Mon.…”

Section: Discussionmentioning

confidence: 53%

“…In this study, the authors suggest investigating whether less than 10 measurements can be sufficient to assess stiffness of the liver properly. The newest EFSUMB guidelines and recommendations on the clinical Use of liver ultrasound elastography (2017) advise the use of at least three 2D SWE measurements and presentation of the results of liver stiffness as median with the interquartile range (13). The number of measurements of liver stiffness has been analyzed in numerous studies.…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Liver Fibrosis in the Real-Time Shear Wave Elastography Technique in Chronic Hepatitis B and C Patients: How Many Measurements Are Necessary to Assign Patients to METAVIR Score Properly?

Zaleska-Dorobisz

Inglot²,

Pawluś

et al. 2018

Hepat Mon

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Background: Hepatic fibrosis is part of chronic liver disorders such as chronic hepatitis, cirrhosis, or metabolic disorders. Twodimensional shear wave elastography (2D SWE) is one of the newest elastography techniques, which enables the assessment of the liver fibrosis in a non-invasive way. Objectives: The aim of the study was to determine how many measurements are necessary to assess liver fibrosis in a healthy population and patients with hepatitis B and C. Methods: We analyzed the retrospective data of 642 patients who underwent the complex ultrasonic abdomen examination and liver 2D SWE examination. We analyzed the statistical differences and the interclass correlation coefficient between the value of the first measurement, the median value of the first three measurements, and the median value of all five measurements. Results: There was no statistical difference between the 2D SWE value of the first measurement and the median value of the first three and the first five measurements in healthy controls. In the group of patients with hepatitis B, the median value of the first five 2D SWE measurements was significantly higher than the value of the first 2D SWE measurement. Our study presented no statistical difference between the median of the first three measurements and the median value of all five measurements in the group of HCV positive patients. The analysis of the assignment to the METAVIR groups with respect to the median value of the first three 2D SWE measurements revealed no statistical difference in comparison with the assignment of patients with respect to the all five 2D SWE measurements of the liver. Conclusions: Depending on the patients' condition, different numbers of 2D SWE measurements can affect the median values of liver stiffness although they do not affect the assignment to the METAVIR scale.

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“…The study protocol was generally according to the guideline with some modification [27]. Most of the examinations were conducted by one experienced technician (H.-T.W.).…”

Section: Arfi Imaging Studymentioning

confidence: 99%

Interpretation US Elastography in Chronic Hepatitis B with or without Anti-HBV Therapy

et al. 2017

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Inflammation has significant impacts on liver fibrosis measurement by ultrasound elastography. The interpretation requires further optimization in patients with or without anti-viral therapy. We prospectively enrolled a consecutive series of patients with chronic hepatitis B who received liver histology analysis and acoustic radiation force impulse (ARFI). 146 patients who underwent liver biopsy (50.9%) or tumor resection (49.1%) were enrolled. 34 patients (23.3%) had been receiving anti-hepatitis B therapy of various duration. The areas under the receiver-operating characteristic (AUROC) for the diagnosis of Metavir F4 by mean ARFI was 0.820 in the non-treatment group and 0.796 in the treatment group. The ARFI tended to be not lower (100%) than the corresponding Metavir grading in patients with treatment within 12 months, equal (75%) from 13 to 31 months, and lower (71.4%) after 32 months. We conclude that ARFI is a reliable tool for measurement of liver fibrosis in chronic hepatitis B patients with ALT (alanine aminotransferase) <5x the upper limit of normal. For those patients under anti-HBV therapy, the optimal timing for ARFI analysis will be over 1-2.5 years of nucleos(t)ide analogue therapy. The ARFI measurement after 2.5 years tends to be lower than the corresponding histology grading.

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EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version)

Cited by 151 publications

References 0 publications

Current Knowledge in Ultrasound-Based Liver Elastography of Pediatric Patients

Current Knowledge in Ultrasound-Based Liver Elastography of Pediatric Patients

The Evaluation of Liver Fibrosis in the Real-Time Shear Wave Elastography Technique in Chronic Hepatitis B and C Patients: How Many Measurements Are Necessary to Assign Patients to METAVIR Score Properly?

Interpretation US Elastography in Chronic Hepatitis B with or without Anti-HBV Therapy

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