Learning curve and interobserver reproducibility evaluation of liver stiffness measurement by transient elastography

Abstract

LSE requires no learning curve: a novice is able to obtain a reliable result after a single training session, whatever the professional status. However, success rate will progressively increase. An LSE with less than four valid measurements should not be considered as reliable.

Non-invasive assessment of liver fibrosis in chronic hepatitis C

“…Limited operator experience, obesity, and more generally features of the metabolic syndrome were the main determinants of LSM failure or unreliable results. This challenges previous claims [67,98] that LSM requires no learning curve and that a novice can consistently obtain reliable results after a short training period. Operator experience influenced not only the success rate, as previously reported [67,98], but also the IQR/LSM ratio, which was recently shown to be critical for LSM accuracy [99].…”

“…This challenges previous claims [67,98] that LSM requires no learning curve and that a novice can consistently obtain reliable results after a short training period. Operator experience influenced not only the success rate, as previously reported [67,98], but also the IQR/LSM ratio, which was recently shown to be critical for LSM accuracy [99]. These findings emphasize the need for rigorous scientific evaluation of all novel procedures, such as TE before their widespread uptake.…”

“…TE reproducibility has been shown to be excellent for both inter-observer and intraobserver agreement, with intra-class correlation coefficients (ICC) of 0.98 [66,67]. However, inter-observer agreement was significantly reduced in patients with lower degrees of hepatic fibrosis, with hepatic steatosis, and with increased body mass index [66], as well as for liver stiffness values \9 kPa [67].…”

Elastography: Principles and considerations for clinical research in veterinary medicine cibele

“…They enable the procedure to be combined with routine real-time ultrasound ultrasound even in overweight patients or in patients with ascites because they generate greater penetration of the mechanical wave. Furthermore, the technique provides better accuracy in the calculation of tissue elasticity and better reproducibility because the result is independent of the skill of the operator (Friedrich-Rust et al, 2009;Muller et al, 2009;Boursier et al, 2010). The primary disadvantages of the shear wave propagation techniques are related to the cost of the device, which often precludes its use outside of reference centers for human and veterinary medicine.…”

Romanian national guidelines and practical recommendations on liver elastography

“…Why Romanian Guidelines? Because in Romania, many FibroScan machines are available (at least [20][21][22][23][24][25], because in many centers "point" shear waves elastography is used in daily practice and because recently, real time shear waves (SWE) elastography became available. On the other hand, many Romanian good quality papers were published in important medical journals, so that the Romanian experience in US based elastography is extensive.…”