Shear Wave Elastography, is a fast, non-invasive test that enables you to quantify the extent of liver fibrosis using confidence maps, multiple samples and real-time elastography. This Shear Wave Technology allows for maximal accuracy. When performed, elastography is always carried out in conjunction with a full hepatobiliary system ultrasound assessment to ensure pathologies are not missed.
Dr Paul Riley, Keystone’s Abdominal Imaging Lead Radiologist describes this technology as “a useful additional imaging tool in sonographic assessment of the liver”. Great for counselling and monitoring the progression of disease, it can accurately stage the degree of liver fibrosis which is essential in determining if antiviral therapy is appropriate and predicting outcomes of treatment and the potential for malignancy.
There are many uses for Shear Wave Elastography including monitoring progression, stabilisation or regression of disease in patients after receiving medical treatment or those instituting lifestyle changes. “It is a useful adjunct in the clinical setting of chronic liver disease, including hepatitis B, C, alcoholic liver disease as well as the increasing prevalence of NAFLD/NASH” says Dr Riley. This technology is a safe, inexpensive and reliable marker of fibrosis. It is also useful in patients with clinically suspected liver disease before other abnormalities are detected with ultrasound. “This new technique is a safe and reliable tool in further characterising chronic liver disease and grading liver fibrosis to influence medical management” says Dr Riley.
Whilst liver biopsy is the gold standard in diagnosing cirrhosis, it is poorly suited for active monitoring because of the expense and co-morbidity. Shear Wave Elastography can assist in counselling patients on their long-term risk of cirrhosis. This technology is also useful in evaluating a baseline “stiffness” value in patients with chronic liver disease.
Shear Wave Elastography is not useful for all patients with acute hepatitis, obstructive cholestasis, suspected liver congestion due to right heart failure or receiving Hepatitis C treatment. Histopathology obtained via biopsy is still the gold standard for assessing liver fibrosis.
To assist in understanding the results, we provide our referrers with a report of any pathologic changes, and a stiffness measurement of the liver parenchyma in kPA. This comes alongside a table from the Society of Radiologists in Ultrasound Consensus Guidelines allowing easy interpretation of results.
This technology helps by identifying and counselling patients that need to make lifestyle changes to reduce long-term risk of cirrhosis, portal hypertension, varices, and HCC risk. Shear Wave Elastography also helps identify if a patient requires increasing surveillance via other methods if their fibrosis progresses.
Shear wave Elastography is available at both of our private outpatient clinics, Sovereign Radiology (Ballarat) and High St Xray (Bendigo).