Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparison
Abstract Background and Aims Fontan‐associated liver disease (FALD) is a long‐term complication of the Fontan procedure. Guidelines recommend elastography, but the utility of transient elastography (TE) and two‐dimensional shear wave elastography (2D SWE) is unknown. We aimed to evaluate the relatio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | JGH Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgh3.12967 |
| _version_ | 1827778776747999232 |
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| author | Madeleine Gill Sanjivan Mudaliar David Prince Nwe Ni Than Rachel Cordina Avik Majumdar |
| author_facet | Madeleine Gill Sanjivan Mudaliar David Prince Nwe Ni Than Rachel Cordina Avik Majumdar |
| author_sort | Madeleine Gill |
| collection | DOAJ |
| description | Abstract Background and Aims Fontan‐associated liver disease (FALD) is a long‐term complication of the Fontan procedure. Guidelines recommend elastography, but the utility of transient elastography (TE) and two‐dimensional shear wave elastography (2D SWE) is unknown. We aimed to evaluate the relationship between TE and 2D SWE in FALD. Methods This prospective cohort study included 25 patients managed in a specialist clinic between January 2018 and August 2021. Trained clinicians performed 2D SWE (GE Logiq‐E9) and TE (FibroScan 503 Touch) on the same day under the same conditions. Laboratory, echocardiography, and imaging data were collected. The atrioventricular systolic‐to‐diastolic duration (AVV S/D ratio) was calculated as a measure of cardiac diastolic function. Results We analyzed 40 paired measurements. Median age was 22 years. Median liver stiffness measurement (LSM) was 15.4 kPa (12.1–19.6) by TE and 8.0 kPa (7.0–10.3) (P = 0.001) by 2D SWE. There was weak correlation between the modalities (r = 0.41, P = 0.004). There was no correlation between time since Fontan and LSM by TE (r = 0.15, P = 0.19) or 2D SWE (r = 0.19, P = 0.13). There was no difference in LSM irrespective of whether sonographic cirrhosis was present or absent by TE (17.4 kPa [15.9–23.6] vs. 14.9 kPa [12.0–19.4], respectively, P = 0.6) or 2D SWE (9.0 kPa [2.8–10.5] vs. 8.0 kPa [6.7–10.1], P = 0.46). There was no correlation between AVV S/D ratio and LSM by TE (r = 0.16, P = 0.18) or 2D SWE (r = 0.02, P = 0.45). Conclusions In FALD, TE and 2D SWE are poorly correlated. LSM by either modality was not associated with known risk factors for liver fibrosis or Fontan function. Based on these data, the role of elastography in FALD is uncertain. |
| first_indexed | 2024-03-11T14:39:36Z |
| format | Article |
| id | doaj.art-054cc86774be4a7fa325939219eafa7a |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-03-11T14:39:36Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-054cc86774be4a7fa325939219eafa7a2023-10-30T15:44:58ZengWileyJGH Open2397-90702023-10-0171069069710.1002/jgh3.12967Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparisonMadeleine Gill0Sanjivan Mudaliar1David Prince2Nwe Ni Than3Rachel Cordina4Avik Majumdar5Australian National Liver Transplant Unit Royal Prince Alfred Hospital Sydney New South Wales AustraliaAustralian National Liver Transplant Unit Royal Prince Alfred Hospital Sydney New South Wales AustraliaAustralian National Liver Transplant Unit Royal Prince Alfred Hospital Sydney New South Wales AustraliaDepartment of Gastroenterology and Hepatology University Hospital Coventry Coventry UKFaculty of Medicine and Health The University of Sydney Sydney New South Wales AustraliaFaculty of Medicine and Health The University of Sydney Sydney New South Wales AustraliaAbstract Background and Aims Fontan‐associated liver disease (FALD) is a long‐term complication of the Fontan procedure. Guidelines recommend elastography, but the utility of transient elastography (TE) and two‐dimensional shear wave elastography (2D SWE) is unknown. We aimed to evaluate the relationship between TE and 2D SWE in FALD. Methods This prospective cohort study included 25 patients managed in a specialist clinic between January 2018 and August 2021. Trained clinicians performed 2D SWE (GE Logiq‐E9) and TE (FibroScan 503 Touch) on the same day under the same conditions. Laboratory, echocardiography, and imaging data were collected. The atrioventricular systolic‐to‐diastolic duration (AVV S/D ratio) was calculated as a measure of cardiac diastolic function. Results We analyzed 40 paired measurements. Median age was 22 years. Median liver stiffness measurement (LSM) was 15.4 kPa (12.1–19.6) by TE and 8.0 kPa (7.0–10.3) (P = 0.001) by 2D SWE. There was weak correlation between the modalities (r = 0.41, P = 0.004). There was no correlation between time since Fontan and LSM by TE (r = 0.15, P = 0.19) or 2D SWE (r = 0.19, P = 0.13). There was no difference in LSM irrespective of whether sonographic cirrhosis was present or absent by TE (17.4 kPa [15.9–23.6] vs. 14.9 kPa [12.0–19.4], respectively, P = 0.6) or 2D SWE (9.0 kPa [2.8–10.5] vs. 8.0 kPa [6.7–10.1], P = 0.46). There was no correlation between AVV S/D ratio and LSM by TE (r = 0.16, P = 0.18) or 2D SWE (r = 0.02, P = 0.45). Conclusions In FALD, TE and 2D SWE are poorly correlated. LSM by either modality was not associated with known risk factors for liver fibrosis or Fontan function. Based on these data, the role of elastography in FALD is uncertain.https://doi.org/10.1002/jgh3.12967cirrhosisechocardiographyelastographyfibrosisFontanliver stiffness |
| spellingShingle | Madeleine Gill Sanjivan Mudaliar David Prince Nwe Ni Than Rachel Cordina Avik Majumdar Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparison JGH Open cirrhosis echocardiography elastography fibrosis Fontan liver stiffness |
| title | Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparison |
| title_full | Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparison |
| title_fullStr | Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparison |
| title_full_unstemmed | Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparison |
| title_short | Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparison |
| title_sort | poor correlation of 2d shear wave elastography and transient elastography in fontan associated liver disease a head to head comparison |
| topic | cirrhosis echocardiography elastography fibrosis Fontan liver stiffness |
| url | https://doi.org/10.1002/jgh3.12967 |
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