Hepatic elastography measures liver stiffness as a non-invasive surrogate for hepatic fibrosis, reducing the need for liver biopsy in patients with chronic liver disease. Both transient elastography (FibroScan) and shear wave elastography (SWE) — integrated into conventional ultrasound systems — are used to quantify fibrosis stage.
Sonographers performing elastography position the transducer over the right lobe of the liver and acquire stiffness measurements in kilopascals (kPa) or meters per second (m/s). Reliable measurements require an appropriate intercostal window, fasting state, and avoidance of the right heart edge. Results are interpreted in the context of liver disease etiology using published fibrosis cutoff values for conditions such as NAFLD, hepatitis B and C, and alcoholic liver disease.
Hepatic elastography is typically performed by sonographers with RDMS (AB) credentials who have received additional training in elastography techniques. It is offered in hepatology clinics, gastroenterology practices, liver transplant programs, and hospital radiology departments. As non-invasive fibrosis assessment replaces biopsy in routine management, elastography competency is becoming a standard expectation for abdominal sonographers.