The most usual procedures nowadays is measure the fibrosis by fibroscan and ultrasonics. It is classified in 4 degrees  form minimum in one to maximum in fourth

In addition, here are studies:

https://www.eurekalert.org/pub_releases/2008-03/w-sfm030308.php

https://www.eurekalert.org/pub_releases/2011-06/w-ndm060211.php

https://www.eurekalert.org/pub_releases/2007-02/jws-ani020107.php

https://www.eurekalert.org/pub_releases/2007-04/jws-asn040207.php

https://www.eurekalert.org/pub_releases/2008-01/w-mte010208.php

https://www.eurekalert.org/pub_releases/2006-09/mc-ldb090706.php

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093601

https://www.sciencedaily.com/releases/2008/01/080102155427.htm

Regards,

Joachim

Dear prof Rodrigo, thanks for updating me about the current state of the art. Would you please also be able to share your valuable opinion if the ability to generate voxelwise HA map could result in better diagnostic/prognostic information? 

It was shown that serum hyaluronic acid (HA) level increases with the development for liver fibrosis.  See Chapman et al. JUM 2017 . Ultrasound Elastography of the liver;What the clinician needs to know for a review of why clinicians need to determine degree of fibrosis.

Chronic liver diseases share a common pathway through the fibrosis that is increase in collagen content which is a diffuse process, but not uniform throughout the liver. Even pathologists not always agree eachother on the grade of fibrosis to be assigned to the same biopsy sample! And pathologists manage only 1/60.000 of the whole liver using dye specific for collagen and then quantifying the so called 'collagen percentage area'.The other important fact is that all lab markers become positive at different states of 'functional' or biological reserve of the organ. Then imaging is of the utmost importance in giving 'in real time' the 'real status of the organ' not only in the intial diagnostic workup guiding the therapeutic approach, but also in checking the effects of the treatment started and the evolution of the clinical case.The whole organ info are best obtained by liver MRE, which, however, is time and money consuming and difficult to use in large number of patients and even in the optimal timing of the followup of these patients. US advanced technology in my opinion will give us the clue to fullfill all the clinical requirements, but it still needs to be 'refined' in all the data it offers. In example the samplings for stiffness quantification usually are made in the segments less frequently and in later stages involved by fibrosis. Last, but not least, what we do measure is the 'tissue stiffness', not the true fibrosis (meant as measurement of collagen content) because the multifactorial contribution of different features (blood flow, biliary pressure, hydrostatic pressure and so on) to the total result (both in kPa and in m/s).

 Dear Dr Masciotra,

Thanks a lot for sharing your valuable insights.

Regards,

Dushyant

Your welcome.

You can find something more in the attached file.

And in these examples you'll can see that US has unique features ;

1) you can change all the settings both related to the technology, to your hand and to the patient (position, respiration, and so on)

2) you can follow in real time what's happening (if you think to a tennis game, CT, MRI, PET, NM show you the score in frames or single picts (although  the inappriopriate term 'Cine MR' is more and more diffuse), while only fluoroscopy and US give the whole videoclip!

And even pathology gives its info only in 'dead tissuese' (not living).

All the best from Italy.

https://www.eurekalert.org/pub_releases/2007-02/jws-ani020107.php

https://www.eurekalert.org/pub_releases/2007-04/jws-asn040207.php

 Dear Dr. Gilani,

Thanks a lot for sharing these informative links.

Regards,

Dushyant