Liver Elastography & Focal Lesion Characterization
Shear wave & strain elastography techniques alongside CEUS protocols for hepatic focal lesion workup
Course Overview
This advanced module addresses two of the most clinically impactful areas of hepatic ultrasound: elastography for fibrosis staging and contrast-enhanced ultrasound (CEUS) for focal lesion characterisation. Participants will develop proficiency in both shear wave and strain elastography techniques, with a thorough understanding of the factors affecting measurement reliability and clinical interpretation.
The focal lesion characterisation component covers the CEUS enhancement patterns of common and uncommon hepatic lesions, including hepatocellular carcinoma, metastases, haemangiomas, and focal nodular hyperplasia. The module integrates LI-RADS and CEUS LI-RADS frameworks for structured reporting in the surveillance setting.
Learning Outcomes
- Perform point shear wave and 2D shear wave elastography with quality-controlled measurements
- Interpret liver stiffness measurements in the context of aetiology and clinical variables
- Apply strain elastography for focal lesion characterisation and lymph node assessment
- Describe CEUS enhancement patterns of common hepatic focal lesions in all phases
- Apply CEUS LI-RADS criteria for HCC surveillance in at-risk populations
- Produce structured hepatic ultrasound reports integrating elastography and CEUS findings
Curriculum
Liver Fibrosis & Elastography Principles
- Hepatic fibrosis staging
- Elastography physics
- Shear wave vs strain techniques
Point & 2D Shear Wave Elastography
- Measurement protocol and quality criteria
- Confounders and pitfalls
- Clinical interpretation thresholds
Strain Elastography
- Strain ratio technique
- Focal lesion assessment
- Lymph node characterisation
CEUS Principles & Technique
- Microbubble contrast agents
- CEUS scanning technique
- Timing and phase recognition
Focal Lesion Characterisation
- HCC, metastases, haemangioma patterns
- FNH and adenoma differentiation
- Uncommon lesion patterns
LI-RADS & Structured Reporting
- CEUS LI-RADS categories
- HCC surveillance protocols
- Integrated hepatic reporting
Prerequisites
- Minimum 3 years abdominal ultrasound experience
- Familiarity with hepatic anatomy and pathology
- Access to elastography-capable equipment recommended
Assessment
Online MCQ examination (70% pass mark) + CEUS case interpretation portfolio