Real-time tissue elastography versus FibroScan for noninvasive assessment of liver fibrosis in chronic liver disease.

Ultraschall in der Medizin (Stuttgart, Germany : 1980)

Friedrich-Rust M, Schwarz A, Ong M, Dries V, Schirmacher P, Herrmann E, Samaras P, Bojunga J, Bohle RM, Zeuzem S, Sarrazin C

2009 Ultraschall Med Volume 30 Issue 5

PubMed 19813157 DOI 10.1055/s-0028-1109488

FibroTest Reliability Independant Team vs. Elastography HCV HBV Metabolic Diseases Alcohol Other liver Disease Fibrosis


Transient elastography (FibroScan, [TE]) and serum fibrosis markers such as the FibroTest (FT) are established methods for the noninvasive staging of liver fibrosis. A study using real-time elastography (HI-RTE), which is integrated in a conventional ultrasound system, was recently published with comparable results to transient elastography. The aim of the present study was to validate real-time elastography using the formulas calculated in previous studies and to compare the results to transient elastography and FibroTest for the noninvasive assessment of liver fibrosis.


One hundred and thirty-four patients with chronic liver disease and either histological assessment of liver fibrosis (n = 112) or proven liver cirrhosis (n = 22) were included in the study. All patients received TE, HI-RTE, and biochemical evaluation on the same day as presentation. The calculation of the elasticity score of real-time elastography was performed in accordance with the two previously published studies.


The Spearman correlation coefficient between transient elastography, real-time elastography and FibroTest with the histological Chevallier score was statistically significant with 0.78, 0.34, and 0.67, respectively (p < 0.01). The diagnostic accuracy expressed as areas under ROC curves was 0.84, 0.69 and 0.85 for the diagnosis of significant fibrosis (F > or = 2), and 0.97, 0.65, and 0.83 for the diagnosis of cirrhosis, respectively.


Real-time elastography in its present form cannot replace transient elastography for noninvasive assessment of liver fibrosis.

Citation Reference: