Vibration-controlled transient elastography

Vibration-controlled transient elastography (VCTE) is the most widely used elastography method and is performed using a purpose-built machine made by a single manufacturer (FibroScan).

VCTE results are reported as the median liver stiffness of multiple measurements in kilopascals (kPa) and range from 1.5 to 75 kPa. The minimum quality criteria for VCTE results to be considered reliable areFerraioli 2018:

• a minimum of 10 valid individual measurements
• a success rate of greater than 60%
• an interquartile range to median ratio of less than or equal to 30%.

These values should be reported with the test result.

When interpreting results from VCTE, the cut-off values for stages of fibrosis vary with disease aetiology (eg for hepatitis C, a liver stiffness of more than 12.5 kPa is the cut-off point for identifying people with cirrhosis). The following 'rule of 5' can be used as a guide:

• less than 5 kPa—no or minimal fibrosis
• less than 10 kPa—rules out cirrhosis, in the absence of other clinical signs
• 10 to less than 15 kPa—suggestive of advanced fibrosis or cirrhosis, but further testing required
• 15 kPa or more—highly suggestive of cirrhosis
• 25 kPa or more—rules in cirrhosis with clinically significant portal hypertension in patients withde Franchis 2021 [Baveno VII]Pons 2021EASL 2021:
  • alcohol-related or viral-related chronic liver disease
  • nonobese (body mass index [BMI] less than 30 kg/m²) nonalcoholic fatty liver disease.