Today, over 500 million people are estimated to be affected by liver disease including fibrosis, cirrhosis, and cancer.
Liver fibrosis develops when scar tissue replaces normal liver tissue as a response to a chronic injury, infection, or inflammation of the liver. Fibrosis can progress to cirrhosis which increases the risks of developing liver cancer.
Assessing the degree of fibrosis early is important to determine the best treatment. In this blog, we’ll take a look at some of the best diagnostic techniques available today.
Liver biopsy has been considered the standard to assess liver damage for a long time. Basically, a small amount of liver is surgically removed and the tissue sample is analyzed, which can take up to a few weeks. The results can also help distinguish between different types of viruses.
Unfortunately, this popular method has significant disadvantages. It is invasive and can cause severe pain. The patient also risks infection, bleeding, gallbladder leak, collapsed lung, and even death. The samples taken are extremely small and their value and accuracy have repeatedly been questioned in medical practice.
Transient Elastography (FibroScan)
Transient elastography, also commonly known as FibroScan, is another popular ultrasound technique used to assess and quantify liver fibrosis. A transducer is used to transmit vibrations to measure the stiffness of the liver. Diseased livers are stiffer than healthy ones. Unlike a liver biopsy, it is non-invasive and the volume measured is at least 100 times bigger. It is also significantly cheaper.
While this method is a clear step above liver biopsy, transient elastography occasionally fails to obtain accurate readings in patients that are obese, older, or have ascites (fluid accumulations). Ascites prevent the propagation of the vibration wave. These problems can be partially overcome with the use of other probes such as the XL+ probe. However, requiring additional transducers for different frequencies or patient sizes can be inconvenient and particularly costly.
Shear Waves Elastography
Shear waves elastography is a technique similar to transient elastography. Essentially, a focused ultrasound beam causes liver tissue to generate shear waves. The velocity of these waves is measured and used to evaluate the stiffness of the liver. Unlike transient elastography, the measurements are not limited by ascites because the ultrasound beam propagates through fluids. As with most ultrasound exams, it is quick and painless, and the results can swiftly be obtained from a radiologist afterwards.
Shear waves elastography is available on a number of select ultrasound machines in addition to their many features. Consequently, liver fibrosis assessments can easily be added to existing ultrasound routine scans and be done in seconds using the same transducer.
Shear Waves vs. Transient Elastography
Ultrasound elastography is now becoming the standard for liver disease assessment. One of the most recent shear waves technique to enter the market is ElastPQ from Philips. We’ve put a table together for a quick comparison between ElastPQ and FibroScan, the pioneer of transient elastography.
Both technologies undeniably offer significant advantages over liver biopsy. Still, ElastPQ clearly wins this comparison especially when factoring the price-to-feature ratio.
The new standard at half the price
Most liver fibrosis assessment equipment can easily run over $80,000, but we found a number of shear waves ultrasound systems that can deliver the same reproducibility and ease of use for half the price!
ElastPQ stands for Elastography Point Quantification which is a highly reproducible tool for assessing liver elasticity. Along with the benefits mentioned in a table above, it is user independent and delivers immediate results without a steep learning curve. ElastPQ is also available on the Philips EPIQ 7, EPIQ 5, and Affiniti 70 ultrasound systems.
While the iU22 offers a wide range of application, it does not specialize in any in particular. The strength of the iU22 lies in its broad application support and superior image quality through xMatrix transducers. If medical professionals require a greater focus and specialization on liver disease for their day-to-day routine, then the Aixplorer’s elastography technology will more than fit the bill.
SuperSonic Imagine Aixplorer with SWE
The Aixplorer is a very specialized machine that features Real-time ShearWave™ Elastography (SWE™). This proprietary technology from SuperSonic Imagine enables physicians to visualize and quantify liver stiffness in a real-time, reliable, and reproducible manner.
A particular innovative feature of the Aixplorer is its ability to visualize the anatomy, tissue stiffness, and blood flow simultaneously in enhanced color imaging. Another staple of this revolutionary device is how information-rich images can be acquired 200 times faster than conventional ultrasound systems.
While this highly specialized system may not be as flexible as the Philips iU22 or the GE Logiq E9 in terms of general imaging, the Aixplorer is still well suited for a variety of clinical situations.
GE Logiq E9 with 2D-SWE
The GE Logiq E9 is yet another extremely stable and reliable premium ultrasound machine that is capable of shear wave elastography along with top-of-the-line women’s health and 4D imaging, radiology, cardiac and vascular applications.
2D-SWE is Logiq’s shear wave elastography technology. As with other ultrasound systems listed in this blog, 2D-SWE provides a non-invasive, color-coded quantitative assessment of tissue stiffness in liver, breast, and small parts applications. With elastography active, measurements can be displayed in kPa or m/s, and the color box and ROI depth and size can be adjusted as needed offering flexibility and convenience.
The GE Logiq E9 is the perfect choice for multi-application clinics. However, medical professionals that will use the system exclusively for one or two applications should instead consider GE’s Voluson line for OB/GYN and 4D, or GE’s Vivid line for more of a cardiac focus.
Embrace the new liver diagnostic standard and save with KPI.