Non-invasive liver elastography (Fibroscan) for detection of cystic fibrosis-associated liver disease

Abstract

Fibroscan is an objective measure and is easy to perform in CF patients, even in children and could provide a valuable tool to detect, and quantify CFLD.

Ultrasound elastography in the noninvasive diagnosis of liver disease in children: A review

“…The TE was comparable to the ultrasound scoring system in evaluating for CFLD, sensitivity of 63% and specificity of 87%. TE was also comparable to the ultrasound scoring system in detection of hepatic fibrosis (30). Similarly, another study found that elasticity values of controls, pancreatic sufficient CF patients and pancreatic insufficient CF patients with an ultrasound showing either normal or homogenously hyperechoic livers, were comparable and significantly lower than in CF patients with heterogenous, nodular livers or with evidence of portal hypertension on ultrasound (P <0.002).…”

“…CFLD may show patchy fibrotic changes early on in the disease process, so liver biopsy may miss a diseased region due to sampling error. Witters et al (30) evaluated sixty-six pediatric cystic fibrosis patients with TE and compared them to a control group of healthy children. Liver disease was defined clinically based on the presence of hepatomegaly or splenomegaly and biochemically based on elevated liver function tests (1.5 times the upper limit of normal for age) for 3-6 months.…”

Pilot study on the use of acoustic radiation force impulse imaging in the staging of cystic fibrosis associated liver disease

“…Liver stiffness as correlate of hepatic fibrosis has been investigated also using a different technique, which is the transient elastography [25,26]. Both the latter studies and our investigation respond to the need for non-invasively staging of hepatic fibrosis in CFLD.…”

Transient elastography and portal hypertension in pediatric patients with cystic fibrosis

“…In 2010, Menten et al [12] studied FibroScan measurements in 134 CF patients and found that the FibroScan values were significantly elevated in patients with sonographic evidence of fibrosis. Witters et al found a significant elevation in the FibroScan values of 66 CF patients with liver disease, as defined by clinical, laboratory, or sonographic markers [13].…”

“…Transient elastography has been used for several years in adults with chronic liver disease to detect cirrhosis and to evaluate the complications of portal hypertension [8,9]. In adults and in children [10][11][12][13], transient elastography is being evaluated for cystic fibrosisassociated liver disease and for the detection of esophageal varices in other causes of cirrhosis in children [14]. The goal of this study was to investigate the relationship between transient elastography values and the presence of esophageal varices in CF patients with liver disease.…”