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Gastroenterology: Shear Wave Elastography

05/03/2017 11:39AM ● Published by Jennifer Gonzalez

By: Erin Pesut 


A new non-invasive procedure using ShearWave Elastography is now available at Fayetteville Gastroenterology Associates. 

Dr. John E. Poulos explains, “ShearWave Elastography (SWE) has emerged as a painless non-invasive test that evaluates liver fibrosis by measuring the velocity of elastic shear waves in the liver tissue generated by a mechanical pulse.”  

SWE measurements are performed in the comfort of the doctor’s office with the patient lying flat or on the left side with an ultrasound probe placed over the liver. While the nurse rolls the probe over the liver, patients can view their results right up on the screen. The higher the elastography scores, or liver stiffness, the more severe the fibrosis or cirrhosis of the liver. No prep is required for this procedure.  

The liver can become scarred due to autoimmune attack, viruses, diabetes, high cholesterol, alcohol or other toxins. This scarring, or fibrosis, can progress to liver cirrhosis. When the liver is scarred or has elements of fibrosis, appropriate treatment may reverse the damage. 

Determining the severity of liver scarring whether it is fibrosis or cirrhosis has important prognostic value in determining the long-term complications of liver disease and treatment options, and duration of therapy. In the past, in order to determine the extent of liver damage, a liver biopsy was the standard method of procedure. This invasive method of biopsy was associated with patient discomfort and, in some cases, serious complications. Plus, it was not ideal for repeated assessments to see how the disease was progressing and affecting the liver. 


 Another option to determine the stage of fibrosis is traditional ultrasounds. While this evaluation is not invasive, it could fail to provide crucial information regarding liver scarring, and with ShearWave Elastography, that is no longer the case.  

ShearWave Elastography is similar to an ultrasound machine, but it focuses specifically on the density and/or stiffness of the liver  

Fayetteville Gastroenterology Associates is the first doctor’s office in Southeastern North Carolina to secure this SWE machine and to offer such testing. In a community where Hepatitis C and Fatty liver disease is prevalent, this type of technology is invaluable, especially since most patients require their staging of fibrosis to determine treatment plans. Most insurance companies require patients have a SWE prior to approving therapy.  

“This is a necessary community service to help patients get appropriate care and treatment,” Tina Casillo, Practice Administrator at Fayetteville Gastroenterology Associates said. “No one else around this area is doing it.”  

Since they have acquired the machine, Fayetteville Gastroenterology has become a certified testing site. Referrals are sent to Fayetteville Gastroenterology for this easy, painless, non-invasive procedure that lasts roughly 15 minutes.  

Results gathered by trained nurses are viewed by physicians to determine if fibrosis and liver elasticity is in the normal to moderate to severe ranges. After results are interpreted, patients can be approved for medication and other proper modes of treatment. 


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