Mistakes in the utilization of vibration-controlled transient elastography in the evaluation of liver fibrosis: a narrative review

Abstract

INTRODUCTION: The degree of fibrosis is the most significant indicator of clinical prognosis in chronic liver disease (CLD). While liver biopsy remains the gold standard for assessing liver disease activity and fibrosis, its invasive nature, potential complications, and high cost have spurred the development of alternative diagnostic methods. This has led to significant interest in noninvasive, cost-effective, and easily replicable techniques for evaluating liver fibrosis. Among these noninvasive tests, vibration-controlled transient elastography (VCTE) has emerged as the most extensively researched and validated imaging-based method for staging liver fibrosis. AREAS COVERED: A selective literature search was conducted across electronic databases (PubMed, MEDLINE, Embase, and Cochrane Library) to identify relevant publications on VCTE. Randomized controlled trials, meta-analyses, systematic reviews, evidence-based clinical practice guidelines and selected expert consensus statements and narrative reviews were included.Given its increasing use, clinicians must know common pitfalls in VCTE applications when evaluating CLD. This review aims to outline these potential errors and provide evidence-based guidelines to help clinicians avoid them, thereby improving the accuracy and utility of VCTE in clinical practice. EXPERT OPINION: The future of VCTE involves improved accuracy, accessibility, and integration, leading to earlier detection and personalized management of CLD.