An ultrasound imaging system comprising: an ultrasound imaging device configured to generate shear wave signals responsive to shear wave tracking echoes received by an ultrasound probe communicatively coupled to the ultrasound imaging device; and a processor integral with or communicatively coupled to the ultrasound imaging device, wherein the processor includes: a shear wave processor configured to calculate tissue stiffness values based, at least in part, on the shear wave signals; an image processor configured to generate an ultrasound image (110, 410, 440, 510, 540) including a graphical overlay (120, 325, 420, 465, 520, 565) of tissue stiffness values for one or more pixels within a region of interest, and a confidence map generator configured to calculate a plurality of confidence factors for each of a plurality of pixels of the ultrasound image, each confidence factor represented as a confidence between 0-100%, and calculate a confidence value for each of the pixels based on the plurality of confidence factors; wherein the ultrasound image is configured to provide, based on the calculated confidence values, an indication of reliability of the tissue stiffness values within the region of interest, and wherein calculating the confidence value for each of the plurality of pixels comprises comparing the plurality of confidence factors and selecting a minimum confidence factor as the confidence value. an ultrasound imaging device configured to generate shear wave signals responsive to shear wave tracking echoes received by an ultrasound probe communicatively coupled to the ultrasound imaging device; and a processor integral with or communicatively coupled to the ultrasound imaging device, wherein the processor includes: a shear wave processor configured to calculate tissue stiffness values based, at least in part, on the shear wave signals; an image processor configured to generate an ultrasound image (110, 410, 440, 510, 540) including a graphical overlay (120, 325, 420, 465, 520, 565) of tissue stiffness values for one or more pixels within a region of interest, and a confidence map generator configured to calculate a plurality of confidence factors for each of a plurality of pixels of the ultrasound image, each confidence factor represented as a confidence between 0-100%, and calculate a confidence value for each of the pixels based on the plurality of confidence factors; a shear wave processor configured to calculate tissue stiffness values based, at least in part, on the shear wave signals; an image processor configured to generate an ultrasound image (110, 410, 440, 510, 540) including a graphical overlay (120, 325, 420, 465, 520, 565) of tissue stiffness values for one or more pixels within a region of interest, and a confidence map generator configured to calculate a plurality of confidence factors for each of a plurality of pixels of the ultrasound image, each confidence factor represented as a confidence between 0-100%, and calculate a confidence value for each of the pixels based on the plurality of confidence factors; wherein the ultrasound image is configured to provide, based on the calculated confidence values, an indication of reliability of the tissue stiffness values within the region of interest, and wherein calculating the confidence value for each of the plurality of pixels comprises comparing the plurality of confidence factors and selecting a minimum confidence factor as the confidence value.