Future applications and directions of liver stiffness studies

Abstract

Due to the broad and complex interplay of the liver with other organs, liver stiffness measurements (LSM) will not be restricted to hepatology but play an increasing role in many other medical areas and disciplines. Apart from liver diseases, specific and highly interesting areas for LSM will be intensive care unit, cardiology, hematology but also the monitoring and screening for potentially liver-harmful therapies by rheumatologists, neurologists, addiction specialists, psychiatrists, etc. Algorithms will further improve in line with novel technical opportunities and artificial intelligence/machine learning. Novel business models will also shape the landscape of elastographic applications. Many more patients and individuals will have access to the so-called low-cost screening mode in order to rule out liver and other confounding pathologies while the expert mode will be restricted to specialists with profound liver and ultrasound knowledge for the clarification of elevated LS. Whether this will also lead to a continued modification of health care structures remains open but desirable since the on-time and onside noninvasive diagnosis with combined elastographic, ultrasound and laboratory testing appears to be an attractive vision for the near future. Finally, the noninvasive ability to measure liver stiffness has opened a new realm for the molecular understanding of liver fibrosis, namely the role of biomechanics of the liver.