How ShearWave Elastography made me avoid a liver biopsy, a patient story:

Some 25 years ago, I was visiting my internist for a routine physical exam, when he informed me that I had mildly elevated liver enzymes.  After determining that this was not caused by alcohol consumption, I was tested for hepatitis and other conditions that could cause liver damage. After exhaustive investigations were indeterminate, an ultrasound exam was ordered to assess whether or not there were detectable fatty deposits. In fact, an ultrasound scan did reveal deposits and I was diagnosed with non-alcoholic steatohepatitis (NASH). Even though I was outwardly thin and fit, overeating and other factors, such as a relatively sedentary lifestyle, were the likely cause.

Fast-forward two decades and  I still had a mildly elevated liver enzyme reading that stayed consistent over the years.  This prompted my internist to suggest that enough time had passed with this condition and the risk of fibrosis needed to be investigated and ruled out. He, therefore, aggressively promoted the idea of a liver biopsy.

Having worked in the healthcare and medical imaging field for the majority of my career, I understood that liver biopsies were painful, had an incidence of morbidity, and did not always accurately represent the condition of the liver as a whole, due to the fact that fibrosis is a diffuse disease. Needle biopsies investigate only a small sample of tissue in such a large organ.  These biopsies run a high risk of missing the fibrotic tissue altogether, which can give misleading, and inaccurate results.
I asked my internist if he was aware of ShearWave™ Elastography imaging which had the ability to scan an entire liver and accurately measure tissue stiffness non-invasively.  I explained that the technology could help to determine if there was fibrosis and quantify the severity.  Open minded, he agreed to investigate through authoritative websites and review clinical articles. The clinical information, validated by prominent clinicians around the world, confirmed that patients could avoid liver biopsies for fibrosis by having an examination with ShearWave™ Elastography.

			My internist was satisfied that if I could have this examination and present him with the images showing that I had no signs of fibrosis, he would not push for a biopsy.  In fact within a month, I would participate in the European Congress of Radiology in Vienna, where my colleagues at SuperSonic Imagine could perform a full liver examination using advanced ShearWave Elastography on their Aixplorer® ultrasound system.  While at the conference, I was examined in front of a large audience, but to my great relief, 15 minutes later, it was clear to the clinicians present that, while there remained some small areas of fatty deposits, my liver showed no stiffness.  That afternoon I sent several images via email to my internist who examined the scans and subsequently declared a clean bill of health.  His order for a biopsy was rescinded and he has since educated his patients and colleagues about this new, non-invasive diagnostic option.