Diagnosing native liver fibrosis and esophageal varices using liver and spleen stiffness measurements in biliary atresia: a pilot study

Tomita, Hirofumi; Ohkuma, Kiyoshi; Masugi, Yohei; Hosoe, Naoki; Hoshino, Ken; Fuchimoto, Yasushi; Fujino, Akihiro; Shimizu, Takahiro; Kato, Miyako; Fujimura, Takumi; Ishihama, Hideo; Takahashi, Nobuhiro; Tanami, Yutaka; Ebinuma, Hirotoshi; Saito, Hidetsugu; Sakamoto, Michiie; Nakano, Masaaki; Kuroda, Takeshi

doi:10.1007/s00247-016-3637-4

Cited by 30 publications

(38 citation statements)

References 34 publications

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“…The study by Tomita H. et al found that liver stiffness measurements exhibited good predictive value for oesophageal varices, with a high AUC (0.90), while spleen stiffness measurements failed to predict oesophageal varices. 20 In contrast, the research by Zhang et al demonstrated that spleen stiffness measured by ARFI predicted oesophageal varices with an AUC of 0.81 and that liver stiffness measurements failed to predict oesophageal varices. 21 Many confounding factors, such as small sample sizes, may have led to contradictory conclusions.…”

Section: Discussionmentioning

confidence: 94%

Diagnostic performance and prognostic value of elastography in patients with biliary atresia and after hepatic portoenterostomy: protocol for a systematic review and meta-analysis

Yan

Zhou

et al. 2021

BMJ Open

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IntroductionBiliary atresia (BA) is a life-threatening disease with persistent neonatal cholestasis and progressive liver fibrosis. Timely non-invasive diagnosis of BA can result in early hepatic portoenterostomy (HPE) and better prognosis. Quantitative elastography enables the non-invasive measurement of liver stiffness. However, the studies on elastography methods in the diagnosis of BA and the prediction of post-HPE outcomes vary in their results and have small sample sizes. Thus, we propose this systematic review and meta-analysis to obtain comprehensive evidence on the value of elastography in BA.Methods and analysisWe will search the PubMed, Embase and the Cochrane Central Register of Controlled Trials databases for studies evaluating the diagnostic performance of elastography in patients with BA and the prognostic value of postoperative elastography, from inception to 31 December 2020. We plan to use the Quality Assessment of Diagnostic Accuracy Studies-2 list and the Quality In Prognosis Studies tool to assess the risk of bias in the included studies and the study quality. We will evaluate the diagnostic performance of elastography by synthesising the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic OR and summary receiver operating characteristic curve using Meta-Disc V.1.4. We will evaluate the predictive value of elastography after HPE by synthesising the pooled correlation coefficient and pooled OR of prognostic outcomes using STATA V.14. The funnel plot and Egger’s test will be used to evaluate the potential publication bias. Sensitivity analysis will be conducted by examining the estimated effects of individual studies.Ethics and disseminationAs this study is a meta-analysis based on previously published literature, ethical approval is not necessary according to the ethics committee of West China Hospital, Sichuan University. The results of this study will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020162055.

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Section: Discussionmentioning

confidence: 94%

Diagnostic performance and prognostic value of elastography in patients with biliary atresia and after hepatic portoenterostomy: protocol for a systematic review and meta-analysis

Yan

Zhou

et al. 2021

BMJ Open

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“…Ultrasound (US) elastography is a non-invasive, quantitative, and accurate diagnostic technique that can identify liver fibrosis without biopsy in various chronic liver diseases (6,7). A few studies have reported the promising diagnostic efficacy of US elastography techniques in patients with postoperative BA by using two-dimensional shear wave elastography (2D-SWE), acoustic radiation force impulse (ARFI) imaging, and transient elastography (TE) (8)(9)(10). However, no reports have documented attempts to compare the diagnostic accuracy of 2D-SWE and TE in BA.…”

Section: Introductionmentioning

confidence: 99%

Assessment of native liver fibrosis using ultrasound elastography and serological fibrosis indices in children with biliary atresia after the Kasai procedure

et al. 2020

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Background Validated non-invasive examinations are necessary to monitor liver fibrosis in children with biliary atresia (BA) after the Kasai procedure. Purpose To evaluate the diagnostic accuracy of two-dimensional shear wave elastography (2D-SWE), transient elastography (TE), and the serologic biomarkers of aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) score for evaluating native liver fibrosis in children with BA. Material and Methods We retrospectively reviewed same-day 2D-SWE and TE liver stiffness (LS) measurements of 63 patients with BA who underwent the Kasai procedure. The APRI and FIB-4 score were computed. Hepatic fibrosis was categorized into three clinical categories based on the ultrasound (US) hepatic morphology and clinical manifestations of liver cirrhosis: I, pre-cirrhotic liver state (n = 15); II, US and/or clinical signs of liver cirrhosis with compensated liver function (n = 27); and III, liver cirrhosis with decompensated liver function (n = 21). We compared area under the receiver operating characteristic curve (AUC) data among 2D-SWE, TE, APRI, and FIB-4 score. Combined evaluation of serologic fibrosis indices and US elastography was conducted and AUCs of combinations were analyzed. Results 2D-SWE, TE, APRI, and FIB-4 score showed good to excellent diagnostic accuracy for differentiating clinical categories (AUCs 0.779–0.955). AUC values were significantly increased after adding TE to FIB-4 score for detecting liver cirrhosis ( P = 0.02). Conclusion 2D-SWE, TE, APRI, and FIB-4 score are accurate non-invasive markers for monitoring native liver fibrosis in patients with BA. Combined use of serologic markers and US elastography could yield more accurate diagnoses of liver fibrosis than serologic markers alone.

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“…14,16,20 The patient populations varied among the included studies, including 4 reports with patients who had various chronic or suspected liver diseases, 11,15,19,20 3 studies with cystic fibrosis cohorts, 10,16,17 and 4 studies with patients who had biliary atresia. [12][13][14]18 The age range of the patients in the 11 included studies was 3 months to 25 years. Table 2 summarizes the technical characteristics of the US elastographic procedures in the included studies.…”

Section: Quality Assessment Of the Included Studiesmentioning

confidence: 99%

Diagnostic Performance of Ultrasound Elastography for Evaluating Portal Hypertension in Children: A Systematic Review and Meta‐analysis

Kim¹,

Yoon

Jung

et al. 2018

J of Ultrasound Medicine

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Diagnosing native liver fibrosis and esophageal varices using liver and spleen stiffness measurements in biliary atresia: a pilot study

Abstract: Liver and spleen stiffness measurements using ARFI imaging are potential noninvasive markers for liver fibrosis and esophageal varices in patients treated for biliary atresia.

Cited by 30 publications

References 34 publications

Diagnostic performance and prognostic value of elastography in patients with biliary atresia and after hepatic portoenterostomy: protocol for a systematic review and meta-analysis

Diagnostic performance and prognostic value of elastography in patients with biliary atresia and after hepatic portoenterostomy: protocol for a systematic review and meta-analysis

Assessment of native liver fibrosis using ultrasound elastography and serological fibrosis indices in children with biliary atresia after the Kasai procedure

Diagnostic Performance of Ultrasound Elastography for Evaluating Portal Hypertension in Children: A Systematic Review and Meta‐analysis

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