Liver ultrasound elastography is a painless, new test available at Medical Imaging of Fredericksburg. It can detect and evaluate liver fibrosis in patients with Hepatitis C, Hepatitis B, non-alcoholic fatty liver disease (NAFLD), and other biliary disorders. It is an alternative to more invasive liver biopsies for determining the degree of fibrosis in patients, noted Neil Patil, MD, a fellowship trained diagnostic radiologist with Radiologic Associates of Fredericksburg who has served as physician director of ultrasound.
“Liver elastography gives gastroenterologists an alternative, noninvasive way to assess the degree of liver fibrosis for initial evaluation and continued monitoring,” Dr. Patil explained. “Patients with Hepatitis C, for example, can be evaluated for new medications based on the degree of fibrosis detected by elastography.”
Following a comprehensive review of relevant literature, the Society of Radiologists in Ultrasound published a consensus statement in 2015. It concluded that elastography techniques can be used to distinguish patients with no or minimal fibrosis from those with severe fibrosis or cirrhosis “with no need for biopsy in these groups unless there are other factors that would lead to biopsy, such as risk of acute flares in chronic hepatitis that would not be appropriately assessed noninvasively.”
Liver fibrosis occurs when scar tissue develops in the liver as the result of chronic conditions such as Hepatitis C, Hepatitis B, and NAFLD. Without treatments that halt or reverse these conditions, fibrosis can progress. The American Liver Foundation cites Hepatitis C, for example, as a leading cause of liver failure and end-stage liver disease, and the Centers for Disease Control and Prevention estimates that approximately 15,000 Americans die each year from Hepatitis C–related liver disease.
When assessing the liver for fibrosis, ultrasound elastography can evaluate larger sections of the liver than a liver biopsy can. It also provides a noninvasive test for tracking the patient’s response throughout the course of treatment, Dr. Patil added. He noted that a liver biopsy is still required for some patients, depending on their condition, but ultrasound elastography is an option in many cases.
Citing one of the cases Medical Imaging of Fredericksburg has handled since introducing the technique in August, an ultrasound elastography test detected severe fibrosis in a middle-aged man with a history of Hepatitis C whose liver had appeared normal using a standard ultrasound. In another case, ultrasound elastography enabled physicians to categorize the degree of significant liver fibrosis in a local patient whose liver biopsy had determined a borderline degree of fibrosis.
Medical Imaging of Fredericksburg is using Philips point shear wave liver elastography (PSWE), a newer, more robust technique than was available previously for liver ultrasound tests, Dr. Patil said. PSWE allows for greater volume sampling of the liver and direct visualization for more accurate results. To use the technique, Radiologic Associates of Fredericksburg’s body imaging radiologists completed a primer covering how liver elastography is conducted, how quality is controlled, and how the evaluation is interpreted.
The cost for liver elastography is $100, and is typically covered by Medicare and most insurance plans.
For More Information
Referring physicians who have questions about ultrasound elastography can contact Dr. Patil through the RAF Physicians Concierge at 1-855-RAF-LINE (1-855-723-5463) or email at Concierge@rafadmin.com. Patients with conditions discussed in this article who would like more information should talk with their physicians.