Shear wave elastography correlates with liver fibrosis scores in pediatric patients with liver disease

Farmakis, Shannon G.; Buchanan, Paula; Guzmán, Miguel A.; Hardy, Anna K.; Jain, Ajay K.; Teckman, Jeffrey

doi:10.1007/s00247-019-04493-3

Cited by 25 publications

(24 citation statements)

References 50 publications

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“…The mean age of the NAFLD patients ranged from 8.5 to 14.1 years and 64% were male (range 24% to 80%). The prevalence ranged from 37% to 98% per study for ≥F1, 17‐30,32,36,37 10% to 48% for ≥F2 17,19‐22,24‐34,36 and 3% to 40% for ≥F3, 17‐22,24‐31,35‐37 based on the 17 studies that reported separate prevalence data.…”

Section: Resultsmentioning

confidence: 99%

“…Sixteen studies used prospectively collected data, one study used retrospectively collected data and in three studies, this was not specified. Thirteen studies reported on the accuracy of detecting mild fibrosis (≥F1), 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 10 studies on detecting significant fibrosis (≥F2) 19 , 20 , 24 , 25 , 29 , 30 , 31 , 32 , 33 , 34 and nine studies on detecting advanced fibrosis (≥F3). 19 , 20 , 24 , 28 , 30 , 31 , 35 , 36 , 37 The time interval between the index test and liver biopsy varied between 0 days and 6 months.…”

Section: Resultsmentioning

confidence: 99%

“…The mean age of the NAFLD patients ranged from 8.5 to 14.1 years and 64% were male (range 24% to 80%). The prevalence ranged from 37% to 98% per study for ≥F1, 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 36 , 37 10% to 48% for ≥F2 17 , 19 , 20 , 21 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 and 3% to 40% for ≥F3, 17 , 18 , 19 , 20 , 21 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 35 , 36 , 37 based on the 17 studies that reported separate prevalence data.…”

Section: Resultsmentioning

confidence: 99%

“…However, a lower number of patients was accepted if the index test was evaluated in at least two studies. Included studies with <60 participants evaluated MRE,20,29 SWE,18,27 TE,23,37 HA21,37 and CK-18 21,33. A limitation of this SR is that summary AUCs or summary sensitivities and specificities could not be calculated for any fibrosis test based on the published data and we did not collect raw data of all included studies.In conclusion, the available data on the accuracy of noninvasive fibrosis tests in children with NAFLD are insufficient to determine their accuracy.…”

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confidence: 99%

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Diagnostic accuracy of fibrosis tests in children with non‐alcoholic fatty liver disease: A systematic review

Draijer

Oosterhout

Vali

et al. 2021

Liver International

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Background & Aims Non‐alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in children. Even at young age, it can progress to liver fibrosis. Given the drawbacks of liver biopsy, there is a need for non‐invasive methods to accurately stage liver fibrosis in this age group. In this systematic review, we evaluate the diagnostic accuracy of non‐invasive methods for staging liver fibrosis in children with NAFLD. Methods We searched MEDLINE, Embase, Web of Science and the Cochrane Library, for studies that evaluated the performance of a blood‐based biomarker, prediction score or imaging technique in staging liver fibrosis in children with NAFLD, using liver biopsy as the reference standard. Results Twenty studies with a total of 1787 NAFLD subjects were included, which evaluated three prediction scores, five simple biomarkers, two combined biomarkers and six imaging techniques. Most studies lacked validation. Substantial heterogeneity of studies and limited available study data precluded a meta‐analysis of the few fibrosis tests evaluated in more than one study. The most consistent accuracy data were found for transient elastography by FibroScan®, ELF test and ultrasound elastography, with an area under the receiver operating characteristics curve varying between 0.92 and 1.00 for detecting significant fibrosis. Conclusion Due to the lack of validation, the accuracy and clinical utility of non‐invasive fibrosis tests in children with NAFLD remains uncertain. As studies have solely been performed in tertiary care settings, accuracy data cannot directly be translated to screening populations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnostic accuracy of fibrosis tests in children with non‐alcoholic fatty liver disease: A systematic review

Draijer

Oosterhout

Vali

et al. 2021

Liver International

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“…Noninvasive US elastography that measures liver stiffness mainly on the basis of brosis could be another option for monitoring brosis in pediatric liver diseases.8 The two-dimensional-shear wave elastography (2D-SWE) value (expressed in kilopascals [kPa]) offers advantages in quantitative assessment, and several studies have reported the clinical utility of 2D-SWE to assess liver brosis in chronic liver disease.9,10,11,12 However, only a few studies have used 2D-SWE to evaluate the clinical signi cance of 2D-SWE liver stiffness in liver diseases in pediatric patients, even though many studies have evaluated the advantages of SWE in adult populations with non-alcoholic fatty liver disease (NAFLD), hepatitis, autoimmune hepatitis, or other liver diseases. [12][13][14][15][16] Therefore, this study evaluated the signi cant factors in uencing liver stiffness values in 2D-SWE, and whether liver stiffness can predict the brosis stage of various childhood liver diseases.…”

Section: Introductionmentioning

confidence: 99%

The Usefulness of Noninvasive Liver Stiffness Assessment Using Shear-Wave Elastography for Predicting Liver Fibrosis in Children

Lee

Choi

Cho

et al. 2020

Preprint

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Background: Pediatric patients with liver disease require noninvasive monitoring for the likelihood of fibrosis progression. The purpose of this study is to evaluate the significant factors affecting liver stiffness values from two-dimensional-shear wave elastography (2D-SWE), and whether liver stiffness can predict the fibrosis stage of various childhood liver diseases.Methods: This study comprised 30 children (22 boys and 8 girls; mean age, 5.1 ± 6.1 years; range, 7 days–17.9 years) who had undergone biochemical evaluation, 2D-SWE examination, and histopathologic analysis with fibrosis grade (F0 to F3), necroinflammatory activity, and steatosis grade between August 2016 and March 2020. The liver stiffness from 2D-SWE were compared between fibrosis stages using the Kruskal-Wallis analysis. The significant affecting factors to liver stiffness were evaluated using univariate and multivariate linear regression analyses. The diagnostic performance was determined from the area under the receiver operating curve (AUC) values of the 2D-SWE liver stiffness.Results: Liver stiffness at the F0-1, F2, and F3 stages were 7.9, 13.2, and 21.7 kPa (P < 0.001). Both of fibrosis stage and necroinflammatory grade were factors significantly associated with liver stiffness (P < 0.001 and P = 0.021). Liver stiffness value could distinguish significant fibrosis (≥F2) with an AUC of 0.950 (cutoff value, 11.3 kPa) and the severe fibrosis (F3 stage) with an AUC of 0.924 (cutoff value, 18.1 kPa). Conclusion: The liver stiffness values from 2D-SWE can be effected through both fibrosis and necroinflammatory grade and can provide excellent diagnostic performance in evaluating the fibrosis stage, even in various liver disease.

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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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Shear wave elastography correlates with liver fibrosis scores in pediatric patients with liver disease

Cited by 25 publications

References 50 publications

Diagnostic accuracy of fibrosis tests in children with non‐alcoholic fatty liver disease: A systematic review

Diagnostic accuracy of fibrosis tests in children with non‐alcoholic fatty liver disease: A systematic review

The Usefulness of Noninvasive Liver Stiffness Assessment Using Shear-Wave Elastography for Predicting Liver Fibrosis in Children

Elastography for Pediatric Chronic Liver Disease

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