Advantages and limitations of imaging techniques.
| Technique | Advantages | Limitations |
|---|---|---|
| TE | Widely validated; bedside; AUROC > 0.9 for cirrhosis | Dedicated device; less accurate in obesity/ascites; false positives |
| pSWE | Standard US; operator selects ROI; high applicability | Narrow range; quality criteria not fully defined |
| 2D-SWE | Real-time; adjustable ROI; wide stiffness range | Learning curve; inflammation may influence |
| MRE | Whole-liver assessment; high accuracy; obesity/ascites feasible | Expensive; MRI required; iron overload limits |
TE: transient elastography; pSWE: point shear wave elastography; 2D-SWE: two-dimensional shear wave elastography; ROI: region of interest; MRE: magnetic resonance elastography; MRI: magnetic resonance imaging.
We would like to thank Dr. Laura Fábrega for assistance with the preparation of Figure 1 with Biorender.
IB, JFC, JC, WD, RE, CGR, HJ, FK, AL, DAM, NMS, CM, HM, CR, PS, OT, and HTZ: Investigation, Writing—original draft, Writing—review & editing. JCFC: Conceptualization, Investigation, Writing—original draft, Writing—review & editing, Supervision. All authors read and approved the submitted version.
Ina Bergheim, Associate Editor of Exploration of Digestive Diseases; Jean Francois Cadranel, Editorial Board Member and Guest Editor of Exploration of Digestive Diseases; Jianguo Chen, Editorial Board member and Guest Editor of Exploration of Digestive Diseases; Wenxing Ding, Associate Editor of Exploration of Digestive Diseases; Robert Eferl, Editorial Board member of Exploration of Digestive Diseases; Carmen Garcia-Ruiz, Editorial Board member of Exploration of Digestive Diseases; Hartmut Jaeschke, Editorial Board member of Exploration of Digestive Diseases; Amedeo Lonardo, Associate Editor and Guest Editor of Exploration of Digestive Diseases; Derek A. Mann, Associate Editor of Exploration of Digestive Diseases; Nahum Méndez-Sánchez, Associate Editor and Guest Editor of Exploration of Digestive Diseases; Han Moshage, Associate Editor of Exploration of Digestive Diseases; Chiara Raggi, Editorial Board member and Guest Editor of Exploration of Digestive Diseases; Pavel Strnad, Editorial Board member of Exploration of Digestive Diseases; Oren Tirosh, Associate Editor and Guest Editor of Exploration of Digestive Diseases; Jose C Fernandez-Checa, the Editor-in-Chief of Exploration of Digestive Diseases, had no involvement in the decision-making or the review process of this manuscript. The other authors declare no conflicts of interest.
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We acknowledge the support from the [PID2022-142956OB-100, PID2023-148803OB-100, and PID2025-173094OB-I00] from Plan Nacional de I+D funded by the Agencia Estatal de Investigación (AEI) and the Fondo Europeo de Desarrollo Regional (FEDER) and from the CIBEREHD; Plan Nacional sobre Drogas del Ministerio Sanidad, Gobierno de España; 2021 SGR 00491 de la Generalidad de Cataluña; as well as support from the National Cancer Institute [PO1 CA281819-01A1] from the NIH; and funding from the European Horizon’s research and innovation program HORIZON-HLTH-2022-STAYHLTH-02 under agreement [No 101095679] to JCFC.
Funding for this work was provided by grants from Associazione Italiana per la Ricerca sul Cancro (AIRC) [IG23117] to Prof. Chiara Raggi. Prof. Raggi is a member of the European Network for the Study of Cholangiocarcinoma (ENSCCA) and participates in the initiative EURO‐CHOLANGIO‐NET and Precision‐BTC‐Network granted by COST ACTION [CA18122, CA22125]. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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