Ultrasound elastography in children — nice to have for scientific studies or arrived in clinical routine?

Abstract

Ultrasound elastography (USE) is a modality that in addition to fundamental B-mode, Doppler, and contrast-enhanced sonography is suitable to make qualitative and quantitative statements about the stiffness of tissues. Introduced more than 20 years ago in adults, USE becomes now a diagnostic tool also in children. The aim of this paper is to describe current available techniques for USE in children. The significance for routine use in children is shown, and further interesting applications are reported.

Increase of liver stiffness and altered bile acid metabolism after triple CFTR modulator initiation in children and young adults with cystic fibrosis

“…A similar increase in liver stiffness measurements was found in paediatric CF patients treated with a different CFTR‐modulating small molecule therapy (Lumacaftor and Ivacaftor) 13 . In hand with several studies confirming ARFI as a valid tool for CFLD assessment 8–12 and the high correlation between ARFI‐measured liver stiffness and increased liver fibrosis, 17–19 our data indicate liver involvement during ETI therapy. As sign of potential liver deterioration, only the aspartate aminotransferase in the young age cohort was increased.…”

“…A similar increase in liver stiffness measurements was found in paediatric CF patients treated with a different CFTR-modulating small molecule therapy (Lumacaftor and Ivacaftor). 13 In hand with several studies confirming ARFI as a valid tool for CFLD assessment [8][9][10][11][12] and the high correlation between ARFI-measured liver stiffness and increased liver fibrosis, [17][18][19] The increase in GCDCA might compromise the hypothesis that ETI treatment ameliorates hepatic cholestasis because of an (rheologic) improvement of bile composition. Hence, serum bile acids could serve as additional, more sensitive biomarkers for CFLD.…”

“…Ultrasound was performed by certified physicians with documentation of the following measures: liver length (midhepatic, cm), portal vein maximum velocity (m/s), Pw-Doppler flow profile of the liver veins (mono-, bi-and triphasic) spleen length (cm); ARFI was performed during breathing arrest and the mean and median values (m/s) were derived from 7 to 10 consecutive measurements of the right liver lobe. As cut-off for group stratification into non CFLD − and CFLD + patients, an ARFI mean SWV value of 1.27 m/s 16,17 was used.…”

Ultrasound Elastography in Children

“…The aim of this review was to present the status of UE use in children as a diagnostic or research tool and to encourage its continuous use in clinical practice and further research. A similar review was already published and could be studied in conjunction with our study [4]; however, our study extends to applications to other tissues not yet presented (pancreas, bladder, salivary glands, skin) and in the context of cardiovascular risk assessment, including new studies not yet presented.…”

“…the operator, an additional limitation also lies in the subject with their habitus and cooperation, which can be insufficient in children [4].…”