Real-Time Elastography in the Assessment of Advanced Fibrosis in Chronic Hepatitis C: Is It Here to Stay?

l l i i h n a w s e iver fibrosis is, undoubtedly, one of the main prognostic facors in liver disease because it determines the development f cirrhosis and its subsequent complications.1 Classically, liver biopsy has been considered the old-standard for liver fibrosis assessment.2 There are limtations associated to liver biopsy, namely sampling bias, bserver variability among pathologists and potentially lifehreatening complications.3 Moreover, information provided y histological evaluation of the liver tissue obtained at iopsy is static, incapable of transmitting dynamic or funcional regarding liver disease. A number of non-invasive diagnostic tools for liver fibrosis valuation have emerged in the last decade, and are generlly defined as serological or mechanical. The most studied lood marker based indices include FibroTest, Fibrosis-4 ndex, Forns Score, aspartate-to-platelet-ratio APRI score nd ELF score. Among mechanical methods are transient lastography (TE), MR elastography, acoustic radiation force mpulse (ARFI), shear wave elastography (SWE) and realime elastography (RTE).4 Real-time elastography is an imaging method that uses onventional ultrasound (US) probes to detect the physical