1) Review principles of MR elastography (MRE) for noninvasive assessment of liver fibrosis. 2) Summarize the literature on diagnostic accuracy of MRE in different liver disease etiologies. 3) Review pitfalls and confounders. 4) Provide guidance on liver MRE reporting and interpretation. 5) Discuss future directions.

1) Introduction: Stiffness as a biomarker of liver fibrosis and clinical significance. 2) Basic principles of MRE. 3) Clinical application detection and staging of liver fibrosis, liver stiffness and histology fibrosis stages, contexts of use and populations. 4) Diagnostic performance: overview of meta-analyses, MRE sequence, disease-specific MRE-determined liver stiffness thresholds. 5) Pitfalls and confounders a. Technical: improper hardware setup, left lobe vs right lobe, wave frequency dependencies, region of interest (ROI) placement. b. Biological: steatosis, iron overload, inflammation, cholestasis and venous congestion, expiration vs inspiration, fasting vs postprandial state. 6) Image interpretation Image analysis and interpretation (wave and elastograms), ROI approaches, stiffness thresholds and disease-specific interpretation. 7) Reporting: what to report, how to report it, QIBA recommendations. 8) Future directions: new contexts of use and applications, technical innovations.