Noninvasive Prediction of Advanced Fibrosis in Pediatric Liver Disease-Discriminatory Performance of 2D Shear Wave Elastography, Transient Elastography and Magnetic Resonance Elastography in Comparison to Histopathology
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Noninvasive Prediction of Advanced Fibrosis in Pediatric Liver Disease-Discriminatory Performance of 2D Shear Wave Elastography, Transient Elastography and Magnetic Resonance Elastography in Comparison to Histopathology. / Nielsen, Jon; Kjær, Mette Skalshøi; Rasmussen, Allan; Willemoe, Gro Linno; Chiranth, Deepthi; Henriksen, Birthe Merete; Borgwardt, Lotte; Grand, Mia Klinten; Borgwardt, Lise; Christensen, Vibeke Brix.
In: Diagnostics, Vol. 12, No. 11, 2785, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Noninvasive Prediction of Advanced Fibrosis in Pediatric Liver Disease-Discriminatory Performance of 2D Shear Wave Elastography, Transient Elastography and Magnetic Resonance Elastography in Comparison to Histopathology
AU - Nielsen, Jon
AU - Kjær, Mette Skalshøi
AU - Rasmussen, Allan
AU - Willemoe, Gro Linno
AU - Chiranth, Deepthi
AU - Henriksen, Birthe Merete
AU - Borgwardt, Lotte
AU - Grand, Mia Klinten
AU - Borgwardt, Lise
AU - Christensen, Vibeke Brix
PY - 2022
Y1 - 2022
N2 - Background: Elastography can be measured with different imaging techniques and is increasingly used for noninvasive assessment of hepatic fibrosis. Little is known about the performance, and interrelation of different elastographic techniques, in prediction of hepatic fibrosis in pediatric liver disease. Objectives: We aimed to determine the discriminatory value for advanced fibrosis (Metavir F3-4) and evaluate the applicability of 2D shear wave ultrasound elastography (USe), Transient Elastography (TE) and Magnetic Resonance elastography (MRe) in pediatric liver disease. Methods: In patients with pediatric liver disease aged 0-19 years, USe, TE and MRe were compared with histopathological fibrosis stage. Multivariate logistic regression models for advanced fibrosis were considered. Discriminative performance was assessed by the area under the receiver operating characteristic curve and the Brier Score. Primary analyses included complete cases. Multiple imputation was used as sensitivity analysis. Results: In 93 histologically evaluated patients USe, TE and MRe were performed 89, 93 and 61 times respectively. With increased liver stiffness values, significantly increased odds for presenting F3-4 were seen in individual models for ALT < 470 U/L, whereas the effect for ALT > 470 U/L was non-significant. Area under the curve and Brier Score for discrimination of advanced fibrosis were 0.798 (0.661-0.935) and 0.115 (0.064-0.166); 0.862 (0.758-0.966) and 0.118 (0.065-0.171); 0.896 (0.798-0.994) and 0.098 (0.049-0.148) for USe, TE and MRe respectively. No significant increase in discriminatory ability was found when combining elastographic modalities. Conclusions: In pediatric liver disease, USe, TE and MRe had a good discriminatory ability for assessment of advanced liver fibrosis, although TE and MRe performed best. In most children with pediatric liver disease, TE is a reliable and easily applicable measure.
AB - Background: Elastography can be measured with different imaging techniques and is increasingly used for noninvasive assessment of hepatic fibrosis. Little is known about the performance, and interrelation of different elastographic techniques, in prediction of hepatic fibrosis in pediatric liver disease. Objectives: We aimed to determine the discriminatory value for advanced fibrosis (Metavir F3-4) and evaluate the applicability of 2D shear wave ultrasound elastography (USe), Transient Elastography (TE) and Magnetic Resonance elastography (MRe) in pediatric liver disease. Methods: In patients with pediatric liver disease aged 0-19 years, USe, TE and MRe were compared with histopathological fibrosis stage. Multivariate logistic regression models for advanced fibrosis were considered. Discriminative performance was assessed by the area under the receiver operating characteristic curve and the Brier Score. Primary analyses included complete cases. Multiple imputation was used as sensitivity analysis. Results: In 93 histologically evaluated patients USe, TE and MRe were performed 89, 93 and 61 times respectively. With increased liver stiffness values, significantly increased odds for presenting F3-4 were seen in individual models for ALT < 470 U/L, whereas the effect for ALT > 470 U/L was non-significant. Area under the curve and Brier Score for discrimination of advanced fibrosis were 0.798 (0.661-0.935) and 0.115 (0.064-0.166); 0.862 (0.758-0.966) and 0.118 (0.065-0.171); 0.896 (0.798-0.994) and 0.098 (0.049-0.148) for USe, TE and MRe respectively. No significant increase in discriminatory ability was found when combining elastographic modalities. Conclusions: In pediatric liver disease, USe, TE and MRe had a good discriminatory ability for assessment of advanced liver fibrosis, although TE and MRe performed best. In most children with pediatric liver disease, TE is a reliable and easily applicable measure.
KW - liver fibrosis
KW - elastography
KW - pediatric liver disease
KW - ultrasound elastography
KW - 2D shear wave elastography
KW - transient elastography
KW - magnetic resonance elastography
KW - MR ELASTOGRAPHY
KW - DIAGNOSTIC PERFORMANCE
KW - ULTRASOUND ELASTOGRAPHY
KW - STIFFNESS MEASUREMENTS
KW - SAMPLING VARIABILITY
KW - ESOPHAGEAL-VARICES
KW - HEPATIC-FIBROSIS
KW - CHILDREN
KW - RELIABILITY
KW - PRINCIPLES
U2 - 10.3390/diagnostics12112785
DO - 10.3390/diagnostics12112785
M3 - Journal article
C2 - 36428845
VL - 12
JO - Diagnostics
JF - Diagnostics
SN - 2075-4418
IS - 11
M1 - 2785
ER -
ID: 329189906