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Transient elastography

Authors

  • Vincent Wai-Sun Wong,

    1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
    2. Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
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  • Henry Lik-Yuen Chan

    Corresponding author
    1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
    2. Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
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  • Conflict of interest: Vincent Wong received a consulting fee from Novartis Pharmaceutical and was a speaker for Echosens, Abbott Diagnostic, Novartis Pharmaceutical, and Roche. Henry Chan is an advisory board member of Bristol–Myers Squibb, Novartis Pharmaceutical, Roche, and Abbott Diagnostic.

Professor Henry Lik-Yuen Chan, Department of Medicine and Therapeutics, 9/F, Prince of Wales Hospital, 30–32 Ngan Shing Street, Shatin, Hong Kong. Email: hlychan@cuhk.edu.hk

Abstract

In clinical practice, it is important to assess the severity of liver fibrosis in patients with various liver diseases to determine the prognosis, decide treatment, and monitor disease progression and response to treatment. Liver biopsy is limited by its invasiveness and patient acceptability. The development of transient elastography provides clinicians with a non-invasive, accurate, and reproducible tool to estimate liver fibrosis. The technique has been validated among many liver diseases and requires only simple training. Due to its non-invasive nature and ease of use, transient elastography can be used repeatedly on patients, and is optimal for large-scale epidemiological studies, in which stable patients with no indication for liver biopsy can also be included. However, falsely-high liver stiffness measurements might occur during acute hepatitis, extrahepatic cholestasis, congestive heart failure, and amyloidosis. Failed acquisition is also common in obese patients. The development of S and XL probes might cater for different population groups, but calibration in patients with liver biopsy is essential.

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