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  • Book
    Mirella Fraquelli, editor.
    Summary: This volume explores the main applications of elastographic techniques in hepatological and gastroenterological diseases, and elaborates on the use of these diagnostic techniques in a broad range of clinical settings; in this regard, it provides a clear critical methodological approach to the correct indication, taking into account the existing diagnostic pathways, the actual diagnostic accuracy of elastographic techniques, and their impact on clinical practice in terms of correct positioning of the test in the diagnostic pathway and clinical outcomes improvement. In the first chapters, which focus on the correct methodology for Diagnostic Accuracy Assessment of non -invasive techniques, the architecture of diagnostic research is discussed. In turn, the following sections describe a broad range of clinical applications in hepatology and gastroenterology. The closing section presents a number of case studies on practical issues, together with a critical discussion on how to promote the appropriate use of these technologies. Given its scope, the book will be of interest to specialists, post-graduate medical students, and researchers in the fields of hepatology and gastroenterology.

    Part I: Introduction to Elastography
    1: Elastographic Measures: A Methodological Approach
    1.1 Phase 0
    1.2 Phase 1
    1.3 Phase 2
    1.4 Phase 3
    1.5 Phase 4
    1.6 Conclusions
    2: Liver Stiffness: Thresholds of Health
    2.1 Preamble: The Concept of Normality in Medicine
    2.2 Healthy Ranges in Liver Disease Diagnostics
    2.3 Definition of Healthy Ranges for Liver Stiffness
    2.4 Conclusions
    Part II: Liver Diseases 3: The Role of Transient Elastography for Fibrosis Staging in HCV-Related Chronic Liver Disease
    3.1 Introduction
    3.2 Assessment of Liver Disease Severity
    3.2.1 Role of Liver Biopsy
    3.2.2 Non-Invasive Assessment of Liver Fibrosis in CHC
    3.3 Transient Elastography for the Assessment of Liver Fibrosis Prior to Antiviral Therapy
    3.3.1 Combination Algorithms
    3.3.2 TE vs. Other Elastography Techniques
    3.4 Transient Elastography for the Assessment of Liver Fibrosis After SVR
    3.5 Transient Elastography for Diagnosing Liver-Related Complications 3.5.1 Portal Hypertension
    3.5.2 Gastro-Oesophageal Varices (GEV)
    3.5.3 Hepatocellular Carcinoma (HCC)
    3.6 Transient Elastography to Determine Prognosis
    3.7 Conclusions
    4: The Role of Elastography in HBV: Assessing Liver Fibrosis
    4.1 Introduction
    4.2 Liver Stiffness Cofactors and Confounders
    4.3 TE in Untreated HBV Carriers
    4.3.1 HBsAg Carriers Without Liver Disease
    4.3.2 Untreated CHB Patients
    4.4 TE in Treated CHB Patients
    4.4.1 LS Kinetics During Antiviral Treatment 4.4.2 Correlation Between LS Changes During Treatment and CHB Outcomes
    4.5 Conclusions
    5: The Role of Transient Elastography in NAFLD
    5.1 Fibrosis in NAFLD: The Burden
    5.2 Transient Elastography: The Technique
    5.2.1 The Procedure
    5.2.2 Probes
    5.2.3 The Role of Controlled Attenuation Parameter (CAP)
    5.2.4 Limitations
    5.3 Transient Elastography in NAFLD: The Quote
    5.3.1 Diagnostic Accuracy
    5.3.2 The Issue of Rule-In and Rule-Out
    5.3.3 Confounding Factors
    5.3.4 Liver Stiffness as Predictor of Liver Events
    5.4 Conclusions References
    6: Elastography in Liver-Transplanted Patients
    6.1 Acute Rejection
    6.2 Recurrent Hepatitis C
    6.3 "Non-viral" Graft Disease After Transplantation
    6.4 Non-alcoholic Fatty Liver Disease (NAFLD)
    6.5 Elastography Outcome After Liver Transplantation
    6.6 Spleen Stiffness and Liver Transplant
    7: Elastography in Autoimmune Liver Diseases
    7.1 Introduction
    7.2 Primary Biliary Cholangitis
    7.3 Primary Sclerosing Cholangitis
    7.4 Autoimmune Hepatitis
    7.5 Conclusions
    Digital Access Springer 2021