Richard Gary Barr MD, PhD, Presenter: Consultant, Siemens AG Consultant, Koninklijke Philips NV Research Grant, Siemens AG Research Grant, SuperSonic Imagine Speakers Bureau, Koninklijke Philips NV Research Grant, Bracco Group Speakers Bureau, Siemens AG Consultant, Toshiba Corporation Research Grant, Esaote SpA

1) To describe the clinical need for liver stiffness evaluation. 2) To describe the principles of ultrasound shear wave liver elastography To review the technique of shear wave liver elastography. 3) To discuss pitfalls in performing and interpreting ultrasound liver elastography To describe the basic approach to interpret ultrasound liver elastography.

Diffuse liver disease is one of the major health problems in the world. Hepatitis C (HCV) and Hepatitis B (HBV) viruses are the leading causes of chronic liver disease. It is estimated that 180 million and 350 million people worldwide are chronically infected with HCV and HBV respectively. In western countries, liver disease caused by HCV is the main indication for liver transplantation. Liver biopsy has been considered the reference standard for fibrosis assessment and stage classification. However, biopsy is invasive, with potential complications that can be severe in up to 1% of cases. In addition, a liver biopsy represents roughly 1/50,000 of the liver volume and there is interobserver variability at microscopic evaluation. Elastography is a non-invasive method for liver fibrosis assessment and has been an area of intense research. With ultrasound elastography systems now widely available worldwide this technique is beginning to replace liver biopsy as method for diagnosis and follow-up of liver fibrosis. This technique is easy to perform but requires attention to detail. This course will review the principles of shear wave elastography (SWE) for liver fibrosis assessment. A review of the technique and pitfalls will be presented. The literature will be reviewed as well as published guidelines on the use of SWE for liver fibrosis assessment. A discussion of the clinical applications of this technique and future potential applications will be discussed.

http://media.rsna.org/media/abstract/2014/14001183/RC217A sec.pdf

Barr, R, US Elastography of the Liver.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001183.html