Comparison of Controlled Attenuation Parameter and Liver Biopsy to Assess Hepatic Steatosis in Pediatric Patients

Abstract

Objective To assess whether the degree of steatosis as determined by Controlled Attenuation Parameter (CAP) measurements correlates with that observed on liver biopsies in a single-center pediatric and young adult cohort. Study design This was a cross-sectional study in patients undergoing liver biopsy as part of standard clinical care between January 25, 2012, and April 1, 2015 at Boston Children’s Hospital. Eligible patients, with a variety of liver diseases, had CAP measurements within 1 year of biopsy. CAP values were compared across histologic steatosis grades using ANOVA. Results Sixty-nine patients (mean age, 16.0 ± 2.9 years; 62% male) were studied. CAP measurements were obtained at a median of 1.3 months (IQR, 0.5–3.2) after biopsy. Of the 69 subjects, 23 had steatosis on biopsy. Mean CAP value (dB/m) for subjects with no steatosis was 198 ± 37 vs 290 ± 47 for subjects with steatosis (P < .0001). There were statistically significant differences between CAP values in individuals with no steatosis vs mild/moderate steatosis (P < .0001), no steatosis vs marked steatosis (P < .0001), and mild/moderate vs marked steatosis (P = .004) Conclusion This study demonstrated a difference in CAP between no steatosis and steatosis, and between grades of steatosis. CAP may be a useful non-invasive tool to detect hepatic steatosis in children.

Noninvasive assessment of liver steatosis in children: the clinical value of controlled attenuation parameter

“…CAP is a new noninvasive method that has shown promise in the assessment of steatosis also in pediatric patients. Recently, in a study performed in a small series of children in whom liver biopsy was carried out for clinical indications, a cut point of 225 dB/m for predicting steatosis has been identified, with 0.87 sensitivity, 0.83 specificity, and AUROC 0.93 [7]. The results of our study show that a CAP cutoff value of 249 dB/m rules in liver steatosis with a very high specificity.…”

Nonalcoholic fatty liver disease in adolescents and young adults: The next frontier in the epidemic

“…However, data in AYAs are limited. A recent study compared CAP measurements with steatosis on liver biopsy in adolescents (mean age, 16) and noted that CAP can detect steatosis and discriminate between its grades . In addition, a study in children and adolescents has shown that VCTE accurately identifies those without fibrosis and subjects with AF (F ≥ 3), but does not differentiate well between lower stages of fibrosis .…”

Fatty Liver Index (FLI) in Predicting Non-alcoholic Fatty Liver Disease (NAFLD)

“…Fibrosis was staged from F0 to F4, F0: absence of fibrosis; F1: perisinusoidal or portal fibrosis; F2: both perisinusoidal and portal fibrosis; F3: septal or bridging fibrosis; and F4 indicate hepatic cirrhosis (17). The reported CAP and LSM measurement was the median of 10 measurements (18). The intraobserver agreement ICC was 0.98 for FibroScan results (19).…”