Virtual touch quantification (VTq) elastography for non-invasive assessment of liver disease and its complications: what the clinician needs to know.

Liver stiffness measurement (LSM) is the most widely used non-invasive alternative to biopsy for assessing liver fibrosis in the UK. Virtual touch quantification (VTq, also known as acoustic radiation force impulse) is the principal available alternative to transient elastography (Fibroscan) and is delivered via software enhancements to standard ultrasound (US) machines. It has recently been endorsed by National Institute for Health and Care Excellence in terms of both accuracy and cost-effectiveness for use in viral hepatitis. However, while an increasing proportion of radiologists use VTq, familiarity among gastroenterologists and trainees with LSM techniques is variable and implementation is patchy. This review considers the background, evidence for and practical use of VTq elastography in clinical practice in the UK. Potential future developments in this rapidly evolving field are also highlighted.