Diagnostic Performance of Transient Elastography for Liver Fibrosis in Children: A Systematic Review and Meta-Analysis

Abstract

Transient elastography showed highly accurate diagnostic performance for the diagnosis of liver fibrosis in children.

Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

“…Additionally, most clinicians and patients (or their parents) prefer noninvasive alternatives to determine the presence or absence of cirrhosis, particularly in the pediatric population. Ultrasound‐based, liver elastography appears increasingly promising for monitoring children and adolescents with chronic HCV infection …”

“…Ultrasound-based, liver elastography appears increasingly promising for monitoring children and adolescents with chronic HCV infection. (232)(233)(234)(235)(236) HCV-related liver disease generally progresses more slowly in children and adolescents compared to adults, although disease progression is unpredictable. (191,221,(237)(238)(239) Despite a paucity of data evaluating risk factors for HCV disease progression in the pediatric population, children with comorbid conditions (e.g., obesity with nonalcoholic fatty liver disease, congenital heart disease with elevated right heart pressures, and HIV and/or HBV coinfection) and those receiving hepatotoxic drugs require careful monitoring.…”

Nonalcoholic Fatty Liver Disease in Children: Unique Considerations and Challenges

“…TE has shown excellent accuracy for predicting the presence and stage of fibrosis in children with biopsy-proven NAFLD and other chronic liver diseases. [140][141][142][143] Shear wave elastography (SWE) and acoustic radiation force impulse (ARFI) elastography are other ultrasonography-based methods that have the benefit of allowing the user to visually select the examination points in the liver to evaluate heterogeneous liver fibrosis. 126,144 ARFI is most accurate in distinguishing between mild and severe fibrosis, using a cutoff value of <2 m/s in children.…”

Nonalcoholic fatty liver disease and hepatic fibrosis among perinatally HIV-monoinfected Asian adolescents receiving antiretroviral therapy

“…TE is a useful technique for detecting hepatic fibrosis since it demonstrates a good correlation with liver histology and liver biomarkers. In a recent meta-analysis, TE showed a highly accurate diagnostic performance for the diagnosis of significant hepatic fibrosis in children and adolescents with a sensitivity, a specificity, and an AUROC curve of 95%, 90%, and 0.96, respectively [18]. MRI/MRE is an advanced technique for the assessment of NAFLD and hepatic fibrosis with the greatest accuracy, but is not widely used because of its high cost [19].…”