Paul Singh Sidhu MRCP, FRCR, Presenter: Speaker, Bracco Group Speaker, Siemens AG Speaker, Hitachi, Ltd

1) Understand the concept of measuring liver stiffness with elastography, methods of elastography in clinical use. 2) Understand the need for the clinical application of liver stiffness measurements in disease management. 3) Review the different techniques available and review evidence of their accuracy. 4) Consolidate knowledge on application, accuracy and position in clinical practice of liver elastography.

Chronic liver disease is a major health problem, representing the end stage of a number of pathological processes arisng from a variety of causative factors. Alcohol misuse remains an important cause but the increasing prevalence of viral hepatitis (Hepatitis B and C) worldwide represents a healthcare issue. Early stages of chronic liver disease, fibrosis prior to the development of cirrhosis, is important to establish as this influences medical mamgement, aimed at halting or slowing the progression to irreversable cirrhosis. Non-invasive markers are often used to predict the presence of liver fibrosis, but ultimately a liver biopsy is needed to stage the degree of fibrosis (usually the METAVIR or ISHAK scores). A liver biopsy is associated with morbidity and mortality, and samples a small volume of the liver, in a disease process that is often patchy. The need for an accurate non-invasive imaging method of assessing the degree of liver fibrosis, in essence the #39;stiffness#39; of the liver, has encouraged the use of elastography to grade liver stiffness by either #39;compression#39; assessment or using shear wave technology. The principles of the different types of elastography will be discussed, the application in assessing chronic liver disease, the evidence for accuracy and the future in clinical practice will be discussed.Chronic liver disease is a major health problem, representing the end stage of a number of pathological processes arising from a variety of causative factors. Alcohol misuse remains an important cause but the increasing prevalence of viral hepatitis (Hepatitis B and C) worldwide represents a healthcare issue. Early stages of chronic liver disease, fibrosis prior to the development of cirrhosis, is important to establish as this influences medical management, aimed at halting or slowing the progression to irreversible cirrhosis. Non-invasive markers are often used to predict the presence of liver fibrosis, but ultimately a liver biopsy is need

Sidhu, P, Liver Elastography.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000565.html