Recommendations and guidelines on ultrasound elastography

The European Federation of Societies of
Ultrasound in Medicine in Biology (EFSUMB) has issued two guidelines and
recommendation papers on ultrasound elastography.

The first of these papers (Bamber et
Ultraschall Med. 2013; 34:169) is the technical part of the guidelines
and recommendations and provides an introduction to the physical principles and
technology on which all forms of current commercially available ultrasound
elastography are based. The paper describes the common underlying physical
mechanism of differences in shear modulus that provides tissue contrast in all
elastograms. The relationship between the alternative technologies is
considered in terms of the method used to take advantage of this. The practical
advantages and disadvantages associated with each of the techniques are
described, and guidance is provided on optimization of scanning technique,
image display, image interpretation and some of the known image artefacts.

The second paper (Cosgrove et al.
Ultraschall Med. 2013; 34:238) assesses the clinically used applications of all
forms of elastography, stressing the evidence from meta-analyses and giving
practical advice for their uses and interpretation. Diffuse liver disease forms
the largest section, reflecting the wide experience with transient and shear
wave elastography . Then follow the breast, thyroid, gastro-intestinal tract,
endoscopic elastography, the prostate and the musculo-skeletal system using
strain and shear wave elastography as appropriate. The documents are intended to
form a reference and to guide clinical users in a practical way. More recently
a third paper (Cui et al. World J Gastroenterol. 2013;19: 6329) gives
comments and illustrations on the guidelines.