Elastography Training for Ultrasound Physicians: Program Structure, Practice, and Enrollment
Structure of the Educational Program
According to the joint position paper by EuSEM and EFSUMB (Osterwalder et al., 2023), the educational program on ultrasound techniques, including elastography, consists of the following components:
| Component | Content |
|---|---|
| Theory | Basics of physics and knobology, indications, anatomy and landmarks, sono-anatomy and sono-pathology, interpretation and integration into patient management |
| Hands-on | Acquisition of practical skills: image generation and optimization, correct display of normal anatomy, pathology, and function |
| Practice | Scanning patients in everyday practice under supervision: presentation of target structures, pattern recognition, integration into clinical decision-making |
Training formats include traditional in-person courses, e-learning, and blended-learning; specific practical skills may be practiced on simulators. Blended approaches are successfully implemented, and the SARS-CoV-2 pandemic has significantly increased the demand for online learning (EuSEM/EFSUMB, 2023).
Practical Skills on the Device
According to the basic EFSUMB Core Curriculum (Andersen et al., 2026), a physician should be able to:
• set up equipment and optimize the image (gain, depth, focus, frequency);
• adhere to the ALARA principle and infection safety rules;
• present anatomical landmarks and structures in two planes;
• describe the localization and characteristics of a lesion (echogenicity, pattern, contours, calcifications, shadow, solid/cystic nature);
• perform measurements;
• inform the patient and obtain consent.
Clinical Basis of Elastography Techniques
The program is based on current guidelines. For non-specific applications — EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018 (Saftoiu et al., 2019) and Part 1: Basic principles and technology (Bamber et al., 2013).
For the liver — WFUMB Guideline on Liver Multiparametric Ultrasound, Part 1 (Ferraioli et al., 2024, update of the 2018 guidelines) including 2D shear wave and point shear-wave elastography, also for assessing spleen stiffness and predicting portal hypertension.
For the thyroid — WFUMB Part 4: Thyroid (Cosgrove et al., 2017) and EFSUMB Multiparametric Ultrasound Thyroid Nodule Evaluation (Cantisani et al., 2026), which discuss strain elastography and quantitative shear wave speed assessment (ARFI). For the scrotum — EFSUMB Guidelines on Multiparametric Ultrasound of the Scrotum (Bertolotto et al., 2026).
CME Credits and Enrollment
The specific number of CME credits, course duration, and enrollment procedure are not provided in the sources — [to be clarified] with the training organizer.
Frequently asked questions
What components does the elastography course consist of?
It consists of theory (physics, knobology, indications, anatomy, interpretation), hands-on skills (image generation and optimization), and practice on patients under supervision with integration into clinical decisions (EuSEM/EFSUMB, 2023).
Is remote learning available?
Yes, in-person courses, e-learning, and blended-learning are used; some practical skills are practiced on simulators. The demand for online learning increased during the SARS-CoV-2 pandemic (EuSEM/EFSUMB, 2023).
Which guidelines does the elastography program rely on?
On EFSUMB Non-Hepatic Applications Update 2018 (Saftoiu et al., 2019), WFUMB Liver Part 1 (Ferraioli et al., 2024), WFUMB Thyroid Part 4 (Cosgrove et al., 2017), and EFSUMB guidelines for the thyroid and scrotum (2026).
What practical skills should a physician master?
Setting up the device and optimizing the image, adhering to ALARA, presenting structures in two planes, describing lesion characteristics, performing measurements, and obtaining patient consent (EFSUMB Core Curriculum, Andersen et al., 2026).
How many CME credits does the course provide and how to enroll?
These details are not provided in the sources — [to be clarified] with the training organizer.