Prospective Assessment of Ultrasound Shear Wave Elastography for Discriminating Biliary Atresia from other Causes of Neonatal Cholestasis

Dillman, Jonathan R.; DiPaola, Frank; Smith, Sally J.; Barth, Richard A.; Asai, Akihiro; Lam, S. K.; Campbell, Kathleen; Bezerra, Jorge A.; Tiao, Gregory M.; Trout, Andrew T.

doi:10.1016/j.jpeds.2019.05.048

Cited by 31 publications

(37 citation statements)

References 13 publications

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“…Virtual Touch Quantification (VTQ) and Virtual Touch IQ (VTIQ) from Siemens are the first two technologies used for the diagnosis of BA [ 47 ], both of which are acoustic radiation force impulse (ARFI)-generated quantitative techniques. As reported, VTQ yielded a sensitivity ranged from 76.9% to 90.9% and specificity ranged from 68.4% to 78.6%, while the sensitivity ranged from 92.3% to 95.5% and specificity ranged from 78.6% to 78.9% of VTIQ [ 47 , 48 , 49 , 50 ]. However, limited number of cases in relevant researches make the reliability of VTQ and VTIQ questioned.…”

Section: Elastographymentioning

confidence: 61%

“…Since the progression of liver fibrosis in patients with BA is faster than that in other neonatal cholestasis, the measurement of liver stiffness might be useful to identify BA among infants with conjugated hyperbilirubinemia, especially when all conventional US features are negative. Elastography can be performed to quantify liver stiffness and fibrosis in infants with cholestasis [ 38 , 39 , 40 ] and to facilitate the differential diagnosis of BA [ 27 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. With the development of elastography technology, various types of elastography have been reported for the diagnosis of BA.…”

Section: Elastographymentioning

confidence: 99%

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Ultrasound for the Diagnosis of Biliary Atresia: From Conventional Ultrasound to Artificial Intelligence

Zhou

2021

Diagnostics

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Biliary atresia is an aggressive liver disease of infancy and can cause death without timely surgical intervention. Early diagnosis of biliary atresia is critical to the recovery of bile drainage and long-term transplant-free survival. Ultrasound is recommended as the initial imaging strategy for the diagnosis of biliary atresia. Numerous ultrasound features have been proved helpful for the diagnosis of biliary atresia. In recent years, with the help of new technologies such as elastography ultrasound, contrast-enhanced ultrasound and artificial intelligence, the diagnostic performance of ultrasound has been significantly improved. In this review, various ultrasound features in the diagnosis of biliary atresia are summarized. A diagnostic decision flow chart for biliary atresia is proposed on the basis of the hybrid technologies, combining conventional ultrasound, elastography and contrast-enhanced ultrasound. In addition, the application of artificial intelligence in the diagnosis of biliary atresia with ultrasound images is also introduced.

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Section: Elastographymentioning

confidence: 61%

Section: Elastographymentioning

confidence: 99%

Ultrasound for the Diagnosis of Biliary Atresia: From Conventional Ultrasound to Artificial Intelligence

Zhou

2021

Diagnostics

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“…In a study of 48 cholestatic neonates, 15 of which were determined to have biliary atresia, LS measured using VCTE was determined to have an AUROC of 0.85 (sensitivity 80%, specificity 97%) for diagnosing BA, using a cut‐off value of >7.7 kPa 83 . A study demonstrated in 41 patients, 13 of whom were diagnosed with BA, that LS was significantly higher in BA patients using pSWE (1.95 vs. 1.21 m/s, p = 0.001), with an AUROC of 0.81 (sensitivity 76.9%, specificity 78.6%) and a cut‐off value of >1.53 m/s 84 . In the same study, 2D‐SWE was demonstrated to have an AUROC of 0.89 (sensitivity 92.3%, specificity 78.6%) using a cut‐off value of >1.84 m/s 84 .…”

Section: Disease‐specific Resultsmentioning

confidence: 99%

Elastography for Pediatric Chronic Liver Disease

Ferraioli¹,

Barr

Dillman

2020

J of Ultrasound Medicine

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In adults with chronic liver diseases, ultrasound and magnetic resonance shear wave elastography (SWE) can replace liver biopsy in several clinical scenarios. Several guidelines on the use of ultrasound SWE for the adult population have been published. However, the number of publications in the pediatric population is limited, and available guidelines on SWE do not specifically address pediatric chronic liver diseases. In this article, we review the literature on the use of SWE for pediatric chronic liver diseases and provide expert opinion on how to use SWE, both ultrasound and magnetic resonance techniques, in the pediatric population.

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“…In the differential diagnosis of cholestatic liver diseases, LSM value was higher in children with biliary atresia than in children with other diseases 26,27 . Zhou et al 24 reported that LSM value was 5.5 kPa in healthy infants.…”

Section: Discussionmentioning

confidence: 98%

“…In the differential diagnosis of cholestatic liver diseases, LSM value was higher in children with biliary atresia than in children with other diseases. 26,27 Zhou et al 24 reported that LSM value was 5.5 kPa in healthy infants. In infants with conjugated hyperbilirubinemia, LSM value was higher in infants with biliary atresia than in those with other diseases (12.6 kPa vs 9.6 kPa).…”

Section: Discussionmentioning

confidence: 99%

Shear wave elastography for evaluation of the urgency of liver transplantation in pediatric patients with biliary atresia

Fang

et al. 2020

Pediatric Transplantation

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Background: To investigate the role of two-dimensional shear wave elastography (2D-SWE) in the preoperative evaluation of pediatric patients with biliary atresia awaiting liver transplantation. Methods: Among a total of 152 pediatric patients enrolled in this single-institution prospective study between March 2018 and August 2019, 143 patients (age range, 4-97 months; median age, 7 months; 84 males, 59 females) who underwent successful routine ultrasound examination, SWE examination, and blood test before liver transplantation were included in the final analysis. The values of liver stiffness measured by SWE were compared with ultrasound and blood test parameters by Spearman's correlation analysis. Results: The overall median liver stiffness with 2D-SWE was 29.0 ± 10.9 kPa, with a range of 9.0-53.3 kPa. The success rate of 2D-SWE measurements was 98.0% (149/152). Liver stiffness measurement (LSMs) had no significant correlation with gender, age, weight, and height of the pediatric recipients. LSMs were correlated with ultrasound parameters including portal vein (PV) maximum velocity, PV direction, hepatic artery resistance index (HARI), spleen diameter, ascites, and blood test parameters (albumin level, platelet count level, and international normalized ratio). In the pediatric recipients with hepatofugal PV flow, high HARI (HARI ≧ 0.90), and ascites, or without Kasai operation, LSMs were significantly higher (P < .05). Conclusions: SWE is feasible and valuable for assessing liver damage in children with biliary atresia awaiting liver transplantation and might be used as selection criteria for children in need of priority access to liver transplantation.

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Prospective Assessment of Ultrasound Shear Wave Elastography for Discriminating Biliary Atresia from other Causes of Neonatal Cholestasis

Cited by 31 publications

References 13 publications

Ultrasound for the Diagnosis of Biliary Atresia: From Conventional Ultrasound to Artificial Intelligence

Ultrasound for the Diagnosis of Biliary Atresia: From Conventional Ultrasound to Artificial Intelligence

Elastography for Pediatric Chronic Liver Disease

Shear wave elastography for evaluation of the urgency of liver transplantation in pediatric patients with biliary atresia

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