Liver elastography - an update

Liver fibrosis evaluation is very important for treatment and prognosis in patients with chronic liver disease. The "gold-standard" method for liver fibrosis assessment is still considered to be the liver biopsy, but in the last years non-invasive methods have increasingly been used, especially ultrasound based elastographic ones. The oldest and the only validated elastographic method for non-invasive liver fibrosis evaluation is Transient Elastography (TE). In the last 2-3 years, similar results to TE for liver fibrosis assessment were obtained by using Acoustic Radiation Force Impulse (ARFI) Elastography. More recently, Real Time Shear Wave Elastography (SWE) was developed and promising results were obtained by this technique. Strain elastography is less used in clinical practice for non-invasive liver fibrosis assessment. TE is also useful for predicting liver cirrhosis complications, especially portal hypertension. ARFI elastography seems to be inferior to TE in this field.