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Ultraschall Med. 2017 Aug;38(4):e16-e47. doi: 10.1055/s-0043-103952. Epub 2017 Apr 13.

EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version).

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Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany.
Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Joint Department of Physics and the CRUK Cancer Imaging Centre, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 15 Cotswold Road, Sutton, London, SM2 5NG, UK.
Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland.
Department of Gastroenterology, Hepatology, Nephrology and Endocrinology, Klinikum Klagenfurt, Klagenfurt am Wörthersee, Austria.
Department of Radiological Sciences, Policlinico Umberto I, University Sapienza, Rome, Italy.
Department of Hepatology, Hopital Beaujon, Assistance Publique-Hôpitaux de Paris, Université Paris VII, INSERM UMR 1149, Clichy, France.
Imaging Departments, Imperial and King's Colleges, London, UM, UK.
Infectious Diseases Dept, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
Department of Internal Medicine 1, J. W.Goethe-University Hospital, Frankfurt, Germany.
National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Norway.
Department of Internal Medicine 1 - Gastroenterology, Pneumology and Endocrinology, University of Erlangen-Nürnberg, Erlangen, Germany.
Department for Internal Medicine, Division of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany.
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Non-invasive diagnosis of liver fibrosis centre, Haut-Leveque hospital, Bordeaux University Hospital, Pessac, France.
Unit of Internal Medicine, Dpt of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy.
Department of Gastroenterology, 3rd Medical Clinic, University of Medicine and Pharmacy "Iuliu Hatieganu". Regional Institut of Gastroenterology and Hepatology "O. Fodor", Cluj-Napoca, Romania.
Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania.
King's College London, Department of Radiology, King's College Hospital, London.
Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania.
Department of Gastroenterology and Hepatology, Odense University Hospital, University of Southern Denmark, Odense, Denmark.


in English, German

We present here the first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography, focused on the assessment of diffuse liver disease. The first part (long version) of these Guidelines and Recommendations deals with the basic principles of elastography and provides an update of how the technology has changed. The practical advantages and disadvantages associated with each of the techniques are described, and guidance is provided regarding optimization of scanning technique, image display, image interpretation, reporting of data and some of the known image artefacts. The second part provides clinical information about the practical use of elastography equipment and the interpretation of results in the assessment of diffuse liver disease and analyzes the main findings based on published studies, stressing the evidence from meta-analyses. The role of elastography in different etiologies of liver disease and in several clinical scenarios is also discussed. All of the recommendations are judged with regard to their evidence-based strength according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. This updated document is intended to act as a reference and to provide a practical guide for both beginners and advanced clinical users.

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Conflict of interest statement

Conflict of interest: Some authors declare conflicts of interest, which are available from the publisher.

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