Pitfalls and sources of variability in two dimensional shear wave elastography of the liver: An overview

Abstract

Abstract Chronic liver diseases are a substantial worldwide problem that are increasing in prevalence. All forms of chronic liver disease have the potential to lead to a deposition of fibrous tissue within the liver resulting in the development of cirrhosis with its consequences – portal hypertension, hepatic failure or hepatocellular carcinoma. In recent years, new treatments for the management of liver fibrosis have been developed. However, the medical field has not been able to meet the demands for a non‐invasive diagnostic and monitoring method in these patients. Magnetic resonance (MR) and ultrasound elastography are rapidly becoming the method of choice for the assessment of liver fibrosis; replacing liver biopsy for diagnosis, evaluation of disease progression and treatment monitoring. However, both MR and ultrasound elastography estimate liver stiffness, of which fibrosis is only one cause. Multiple confounding factors are present. This paper looks at these potential sources of variability that sonographers need to consider when undertaking an hepatic two‐dimensional shear wave elastogram.