Foreword to the WFUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography

Abstract

The recent trend of a significant increase in publications on elastography evoked the World Federation for Ultrasound in Medicine and Biology (WFUMB) to feel the urgent need to create guidelines on the clinical use of elastography. At the WFUMB congress in Vienna inAugust2011,the WFUMBleadership decidedtotakeinitiativeto create the guidelines; the first consensus meeting was held in March 2013 in Washington, DC, and this was followed by sponsoring an elastography consensus session at the WFUMB Congress in San Paolo in May 2013. This is the first time that elastography experts from around the world have come together to create unified guidelines on the clinical use of this technique. Conventional ultrasound echography portrays differences in the acoustic properties of soft tissues (mainly echogenicity but also, to some extent, attenuation), whereas elasticity imaging (elastography)portraysdifferencesintheirelasticproperties(e.g.,elasticity and viscosity). The effective medical use of the two modalities in combination therefore requires sophisticated judgment based on knowledge of how tissue differences and pathologies influence these two different types of mechanical characteristics. Furthermore, the rapid dissemination of ultrasound elastography machines into the market place, the range of apparently different elasticity imaging methodsavailableandthedauntingresearchliteratureonthephysics and medical applications of elastography have created a potentially confusing situation for those who may be considering using elastography. The definite need was therefore strongly felt by the WFUMB to create this set of guidelines and recommendations on the clinical use of ultrasound elastography, which is divided into two clinical papers, each dealing with an existing important application of elastography (of the liver and breast), and to precede these with a basic paper, the goal of which is to introduce the fundamental physics and associated terminology underlying elastography technologies. A similar set of guidelines has been published recently by the Euro