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Advantages and disadvantages of noninvasive methods to evaluate liver fibrosis

Advantages and disadvantages of noninvasive methods to evaluate liver fibrosis
Parameters Transient elastography pARFI 2D-SWE MR elastography Serum biomarkers
Advantages High accuracy, rapid results High accuracy, rapid results High accuracy, rapid results High accuracy Availability
Reproducibility Reproducibility Reproducibility Reproducibility Reproducibility
Very easy to learn Easy to learn Easy to learn, larger measurement area than other ultrasound techniques Examination of the whole liver  
  Conventional ultrasound images are also obtained Conventional ultrasound images are also obtained Conventional MR images are also obtained  
  Obesity and ascites are not limiting Ascites is not limiting Obesity and ascites are not limiting  
Disadvantages Technical requirements (elastography equipment) Technical requirements (ultrasound equipment) Technical requirements (ultrasound equipment) Technical requirements (MR imaging equipment) Nonspecific (eg, hyperbilirubinemia, hemolysis, inflammation)
Intermediate cost Intermediate cost Intermediate cost High cost, time-consuming Relatively high cost, limited availability (patent)
Limited recognition of intermediate stages of fibrosis Limited recognition of intermediate stages of fibrosis Limited recognition of intermediate stages of fibrosis Limited recognition of intermediate stages of fibrosis Limited recognition of intermediate stages of fibrosis
Blind selection of measurement area     Not applicable in case of iron deposition Results not immediately available
Restricted value in obese patients and patients with ascites Narrow range of values, small measurement area      
False positive values in patients with acute hepatitis, cholestasis, and heart failure Quality criteria not well-defined Quality criteria not well-defined    
pARFI: point-shear wave elastography using acoustic radiation force impulse; 2D-SWE: two-dimensional shear wave elastography; MR: magnetic resonance.
Reference:
  1. Cui XW, Friedrich-Rust M, De Molo C, et al. Liver elastography, comments on EFSUMB elastography guidelines 2013. World J Gastroenterol 2013; 19:6329.
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