Ultrasound Elastography for Biomedical Applications and Medicine

20 Transient Elastography: From Research to Noninvasive Assessment of Liver Fibrosis Using Fibroscan®

Laurent Sandrin¹, Magali Sasso¹, Stéphane Audière¹, Cécile Bastard¹, Céline Fournier¹, Jennifer Oudry¹, Véronique Miette¹ and Stefan Catheline²

¹ Echosens, Paris, France

² LabTAU, INSERM‐University of Lyon, France

20.1 Introduction

Initially developed with the critical aim of improving the management of deadly breast and prostate cancers, elastography eventually succeeded in the field of diffuse liver diseases. As a matter of fact, liver diseases are very common diseases which have long been known as affecting liver stiffness. In Aphorisms from more than two thousand years ago, Hippocrates noticed that it is a bad sign if the liver becomes hard during a jaundice. The breakthrough of quantitative elastography of the liver came with the development of Vibration‐Controlled Transient Elastography based FibroScan® which is now considered as the noninvasive standard for the measurement of liver stiffness. Today liver stiffness is widely used as a surrogate marker of liver fibrosis, which is part of the structural and functional alterations in most chronic liver diseases. Among chronic liver diseases, hepatitis C and B lead to nearly 1.4 million deaths every year according to the World Health Organization. The principles of transient elastography are presented in this chapter. The FibroScan® device is detailed, along with a clinical review of its applications to liver ...