American Gastroenterological Association Institute Guideline on the Role of Elastography in the Evaluation of Liver Fibrosis

2017 BMC Gastroenterology 15;1 (183)

Management of patients with Chronic Viral Hepatitis C
Recommendation: In patients with chronic hepatitis C, the AGA recommends VCTE, if available, rather than other nonproprietary, noninvasive serum tests (APRI, FIB-4) to detect cirrhosis.
Recommendation: In patients with chronic hepatitis C, the AGA suggests a VCTE cutoff of 12.5 kPa to detect cirrhosis
Recommendation: In noncirrhotic patients with HCV who have achieved SVR after antiviral therapy, the AGA suggests a post-treatment vibration controlled transient elastography cutoff of 9.5 kPa to rule out advanced liver fibrosis.
Recommendation: In adult patients with chronic hepatitis C, the AGA suggests using VCTE rather than MRE for detection of cirrhosis. Management of patients with chronic hepatitis B:
Recommendation: In patients with chronic hepatitis B, the AGA suggests VCTE rather than other nonproprietary noninvasive serum tests (ie, APRI and FIB-4) to detect cirrhosis.
Recommendation: In patients with chronic hepatitis B, the AGA suggests a VCTE cutoff of 11.0 kPa to detect cirrhosis.

Management of patients with Alcoholic Liver Disease
Recommendation: In patients with chronic alcoholic liver disease, the AGA suggests a VCTE cutoff of 12.5 kPa to detect cirrhosis. Prediction of oseophageal varices:
Recommendation: In patients with suspected compensated cirrhosis, the AGA suggests a vibration controlled transient elastography cutoff of 19.5 kPa to assess the need for esophagogastroduodenoscopy to identify high risk esophageal varices.

Management of patients with portal hypertension
Recommendation: In patients with suspected chronic liver disease undergoing elective nonhepatic surgery, the AGA suggests a VCTE cutoff of 17.0 kPa to detect clinically significant portal hypertension to inform preoperative care.

Pubmed : 28442119