Shear Wave Elastography in the Evaluation of Liver Fibrosis in Children

Tutar, Onur; Beşer, Ömer Faruk; Adaletli, İbrahim; Tunc, Necmettin; Gülcü, Didem; Kantarcı, Fatih; Mihmanlı, İsmail; Çokuğraş, Fügen; Kutlu, Tufan; Özbay, Gülşen; Erkan, Tülay

doi:10.1097/mpg.0000000000000329

Cited by 76 publications

(62 citation statements)

References 23 publications

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“…For example, a recent study by Matos et al [22] using VTQ and a 4C1 transducer determined normal pediatric liver SWS to be 1.07 m/s, on average, while a study by Fontanilla et al [23] using a 9L4 transducer found normal pediatric liver SWS to be 1.15 m/s, on average. Another recent study, by Tutar et al [15], using a different US system (SuperSonic Imagine, Aix-en-Provence, France) determined normal pediatric liver SWS to be 1.56 m/s, quite similar to our results.…”

Section: Discussionsupporting

confidence: 91%

Ultrasound shear wave speed measurements correlate with liver fibrosis in children

et al. 2015

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Section: Discussionsupporting

confidence: 91%

Ultrasound shear wave speed measurements correlate with liver fibrosis in children

et al. 2015

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“…Tutar et al [23] showed that although liver fibrosis can be assessed using 2D-SWE in children, differentiation of mild to moderate fibrosis stages (F1, F2) could not be achieved. The presence of steatosis significantly increased the mean 2D-SWE values on elastography and care should be taken when assessing children with nonalcoholic steatohepatitis [23].…”

Section: Discussionmentioning

confidence: 99%

Comparison of three ultrasound based elastographic techniques in children and adolescents with chronic diffuse liver diseases.

et al. 2016

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Non-invasive techniques for liver fibrosis assessment were developed for adults and recent researches tested their accuracy in children. The only validated elastographic method for non-invasive liver fibrosis evaluation in children is Transient Elastography (TE). The aim of our study was to investigate the feasibility of liver stiffness (LS) measurement in paediatric patients with chronic liver diseases by means of Acoustic Radiation Force Impulse Elastography (ARFI) and 2D-Shear Wave Elastography (2D-SWE), compared to TE as reference method. Material and methods: We enrolled 54 consecutive children and adolescents with different chronic liver diseases. All patients were examined by means of TE, ARFI, and 2D-SWE. All measurements were performed in the right liver lobe, in the same session, in fasting condition. We considered reliable LS elastographic measurements as follows: for TE and ARFI -the median value of ten measurements with a success rate≥60% and an interquartile range<30%, for 2D-SWE -the median value of five measurements. Results: The successful measurement rate for TE was 94.4% (51/54). Taking TE as a reference method, sensitivity of ARFI for detecting fibrosis F1 was 71.42%, for F2-77.77%, for F3-62.5% and for F4-71.42%. Sensitivity of 2D-SWE for detecting F1 was 92.85%, for F2-83.33%, for F3-87.5% and for F4-85.71%. We found significant correlations between TE and 2D-SWE on the entire lot (Kappa correlation factor=0.843, p=0.001). Analyzing the subgroup with SR=60%-70%, we did not find significant correlation between TE and ARFI (Kappa correlation factor=0.172, p=0.452). Assessing the subgroup with SR>70%, we found a significant correlation between TE and ARFI (Kappa correlation factor=0.761, p=0.001). Conclusions: Overall, 2D-SWE correlate better with TE compared to ARFI in children. Excluding patients with less satisfactory technical parameters, we obtained significant correlations between all three methods. Both SWE and ARFI are non-invasive techniques feasible of performing on paediatric patients along with TE.

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“…This is expected to overcome the limitations of transient elastography, where liver stiffness cannot be measured accurately in patients with severe obesity, and ascites. Some articles have shown growing evidence for the accuracy of US elastography [33][34][35][36][37] (Table 1). Although the low reproducibility of measurements derived from operator-dependent performance remains a significant limitation of US elastography, this technique is a useful diagnostic tool for hepatic fibrosis and further validation is warranted.…”

Section: A B Cmentioning

confidence: 99%

Prediction of liver cirrhosis, using diagnostic imaging tools

Yeom

Lee

Hoon

et al. 2015

WJH

104

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Early diagnosis of liver cirrhosis is important. Ultrasoundguided liver biopsy is the gold standard for diagnosis of liver cirrhosis. However, its invasiveness and sampling bias limit the applicability of the method. Basic imaging for the diagnosis of liver cirrhosis has developed over the last few decades, enabling early detection of morphological changes of the liver by ultrasonography (US), computed tomography, and magnetic resonance imaging (MRI). They are also accurate diagnostic methods for advanced liver cirrhosis, for which early diagnosis is difficult. There are a number of ways to compensate for this difficulty, including texture analysis to more closely identify the homogeneity of hepatic parenchyma, elastography to measure the stiffness and elasticity of the liver, and perfusion studies to determine the blood flow volume, transit time, and velocity. Amongst these methods, elastography using US and MRI was found to be slightly easier, faster, and able to provide an accurate diagnosis. Early diagnosis of liver cirrhosis using MRI or US elastography is therefore a realistic alternative, but further research is still needed.

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Shear Wave Elastography in the Evaluation of Liver Fibrosis in Children

Abstract: Although liver fibrosis can be detected using SWE, differentiation of fibrosis stages could not be achieved. The presence of steatosis significantly increased the mean SWE values on elastography and so care should be taken when assessing children with nonalcoholic steatohepatitis.

Cited by 76 publications

References 23 publications

Ultrasound shear wave speed measurements correlate with liver fibrosis in children

Ultrasound shear wave speed measurements correlate with liver fibrosis in children

Comparison of three ultrasound based elastographic techniques in children and adolescents with chronic diffuse liver diseases.

Prediction of liver cirrhosis, using diagnostic imaging tools

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