Technical and Clinical Biases of Transient Elastography in Liver Diseases

Transient elastography has been the mostly well established technique to be used for the assessment of hepatic stiffness. So far, it has the strongest body of evidence. It is known as a user-friendly procedure, requiring only a short procedure time, and offering immediate results and high patient acceptance rates. Nevertheless it is characterized by a series of technical and clinical biases. Our study aims at critically assessing these biases in order to emphasize a thorough algorithm for patient examination. Both procedure and patient-dependent factors can influence the results. TE findings should be processed by specially trained examinators, furthermore the results always have to take into account patient related parameters like personal constitutional indexes, possible causes of the disease and precise biochemical parameters - all strictly correlated with instructions of the manufacturer.