Real-time tissue elastography (RTE) for noninvasive evaluation of fibrosis in liver diseases in children in comparison to liver biopsy

The World Federation for Ultrasound in Medicine and Biology has produced these guidelines for the use of elastography techniques in liver diseases. For each available technique, the reproducibility, results and limitations are analyzed, and recommendations are given. This set of guidelines updates the first version, published in 2015. Since the prior guidelines, there have been several advances in technology. The recommendations are based on the international published literature, and the strength of each recommendation is judged according to the Oxford Centre for Evidence-Based Medicine. The document has a clinical perspective and is aimed at assessing the usefulness of elastography in the management of liver diseases.

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“…Published evidence obtained with SE in children is scarce and contradictory (Schenk et al 2014a(Schenk et al , 2014bSelmi et al 2014).…”

Section: Examination Technique and Normal Valuesmentioning

confidence: 99%

Liver Ultrasound Elastography: An Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations

Ferraioli

Wong

Castéra

et al. 2018

Ultrasound in Medicine & Biology

442

399

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“…Regarding age, Schenk et al (5) found similar results in a study of 34 children (17 females and 17 boys, mean age 10.53 ±5.66 years), when comparing the usefulness of ultrasonic elastography to liver biopsy in pediatric liver disorders.…”

Section: Discussionmentioning

confidence: 60%

“…RTE measures, according to Schenk et al (5) , allow for the classification of high fibrosis, although their connection with the fibrosis stage is modest. RTE appears to be a viable approach for assessing liver fibrosis in youngsters.…”

Section: Discussionmentioning

confidence: 99%

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Role of Ultrasonic Elastography in the Evaluation of Fibrosis in Children with Chronic Liver Disease in Comparison to Liver Biopsy

Hadhod¹,

Mourad²,

Radwan³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Chronic liver illnesses can be caused by a variety of factors, including metabolic, genetic, drug-induced, inflammatory, structural, dietary, and immunological factors. Even with Computed Tomography (CT) scans or Magnetic Resonance Imaging (MRI), liver fibrosis makes diagnostic imaging difficult in chronic liver injury. Percutaneous liver biopsy is the gold standard for diagnosing, grading, and monitoring liver fibrosis in children, but it is painful, invasive, requires heavy sedation, and has numerous complications such as bleeding. Objectives: The aim of the current work was to assess and measure liver stiffness in children with chronic liver disease using real-time elastography (RTE), compare the results to histopathological findings obtained after performing a percutaneous liver biopsy, and investigate the availability of noninvasive safe liver elastography as a future replacement for this invasive tool in the evaluation and grading of liver fibrosis. Patients and methods: This hospital-based cross-sectional comparative study included a total of 30 individuals with chronic liver disease of various etiologies with age ranged from 4-16 years, attending at Department of Pediatric, Sohag University Hospitals. This study was conducted between January 2017 to December 2019. A control group of ten healthy people was also included in the investigation. Results: The degree of liver stiffness measured by the last ultrasonic elastography was greater in the patient group than in the control group, with a statistically significant difference between the two groups. Except for F0-F1 and F3-F4, there was a substantial relationship between fibrosis stage and liver stiffness assessment by sonoelastography, where the difference was significant between every two individual groups. There was a strong link between biopsy diagnosis and liver stiffness measurement. Conclusion: It could be concluded that in adults, ultrasonic elastography is a well-established approach for assessing liver fibrosis. The utility of elastography in the follow-up of children with chronic liver disease might be increased.

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“…Morikawa et al[67] analysed RTE in 101 adult patients with hepatitis c and found a good correlation of the RTE values with the histologic grading of fibroses. In contrast, data obtained from children in another study[68] showed only a moderate correlation, and it was concluded that RTE could not be recommended for a clear differentiation of fibrosis stages while the difference between stage IV fibrosis and normal liver tissue or stage I fibrosis was significant.…”

Section: Sonoelastrographymentioning

confidence: 84%

Limitations and opportunities of non-invasive liver stiffness measurement in children

Engelmann¹,

Quader²,

Teufel³

et al. 2017

WJH

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Changes in liver structure are an important issue in chronic hepatopathies. Until the end of the 20th century, these changes could only be determined by histological analyses of a liver specimen obtained via biopsy. The well-known limitations of this technique (i.e., pain, bleeding and the need for sedation) have precluded its routine use in follow-up of patients with liver diseases. However, the introduction of non-invasive technologies, such as ultrasound and magnetic resonance imaging, for measurement of liver stiffness as an indirect marker of fibroses has changed this situation. Today, several non-invasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness. This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children, and discusses their features in comparison to the “historical” tools.

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Real-time tissue elastography (RTE) for noninvasive evaluation of fibrosis in liver diseases in children in comparison to liver biopsy

Abstract: RTE parameters enable a possible differentiation of high fibrosis; however, their correlation with fibrosis stage was moderate. RTE seems to be a promising method in liver fibrosis grading in children.

Cited by 11 publications

References 33 publications

Liver Ultrasound Elastography: An Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations

Liver Ultrasound Elastography: An Update to the World Federation for Ultrasound in Medicine and Biology Guidelines and Recommendations

Role of Ultrasonic Elastography in the Evaluation of Fibrosis in Children with Chronic Liver Disease in Comparison to Liver Biopsy

Limitations and opportunities of non-invasive liver stiffness measurement in children

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