Frontiers in Pediatrics (Apr 2022)

Noninvasive Pediatric Liver Fibrosis Measurement: Two-Dimensional Shear Wave Elastography Compared With Transient Elastography

  • Léa Chantal Tran,
  • Delphine Ley,
  • Delphine Ley,
  • Gurvan Bourdon,
  • Stéphanie Coopman,
  • Héloïse Lerisson,
  • Céline Tillaux,
  • Hélène Béhal,
  • Frédéric Gottrand,
  • Frédéric Gottrand,
  • Madeleine Aumar,
  • Madeleine Aumar

DOI
https://doi.org/10.3389/fped.2022.849815
Journal volume & issue
Vol. 10

Abstract

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ObjectivesAlthough transient elastography (TE) is the primary noninvasive method for assessing liver fibrosis, its use remains to be validated in children. This study aims to evaluate the agreement between two-dimensional ultrasound shear wave elastography (2D-SWE) and TE to assess pediatric liver stiffness method.MethodsDuring the 18-month study, we prospectively included 101 consecutive children (median age: 8.5 years, range: 1 month to 17 years) who required TE for medical reasons, and in whom 2D-SWE measurement was performed within a 3-month follow-up during a routine ultrasound. Liver elasticity values were classified according to the Metavir score using published pediatric norms for TE and according to the manufacturer's reference values for 2D-SWE. The Spearman's correlation coefficient was used to assess the relationship between the elasticity measured by the two techniques. Concordance was described by the Bland–Altman method.ResultsA strong correlation (rho = 0.70, p < 0.001) was found between 2D-SWE and TE for the elasticity measures. The strength of correlation was higher among patients older than 6 years (rho = 0.79, p < 0.001). Concordance between liver fibrosis stages assessed by these techniques was moderate [weighted kappa = 0.46, (95% CI: 0.35–0.57)]. When considering stages over F2, 2D-SWE diagnostic performances showed a sensitivity of 85% (95% CI: 74–92) and a specificity of 57% (95% CI: 42–70) compared with TE.ConclusionMeasurements of the liver stiffness using 2D-SWE and TE are strongly correlated. The moderate concordance between these techniques for assessing the liver fibrosis stage provides evidence against alternating between these methods during follow-up of patients with the chronic liver diseases.

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