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
<i>Background</i>: 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...
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MDPI AG
2022-11-01
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| Online Access: | https://www.mdpi.com/2075-4418/12/11/2785 |
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| author | Jon Nielsen Mette Skalshøi Kjær Allan Rasmussen Deepthi Chiranth Gro Linno Willemoe Birthe Merete Henriksen Lotte Borgwardt Mia Klinten Grand Lise Borgwardt Vibeke Brix Christensen |
| author_facet | Jon Nielsen Mette Skalshøi Kjær Allan Rasmussen Deepthi Chiranth Gro Linno Willemoe Birthe Merete Henriksen Lotte Borgwardt Mia Klinten Grand Lise Borgwardt Vibeke Brix Christensen |
| author_sort | Jon Nielsen |
| collection | DOAJ |
| description | <i>Background</i>: 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. <i>Objectives</i>: 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. <i>Methods:</i> 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. <i>Results</i>: 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. <i>Conclusions</i>: 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. |
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| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T18:23:57Z |
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| spelling | doaj.art-e6127b520e3547e48cc48c9edfb92bd22023-11-24T08:04:15ZengMDPI AGDiagnostics2075-44182022-11-011211278510.3390/diagnostics12112785Noninvasive Prediction of Advanced Fibrosis in Pediatric Liver Disease—Discriminatory Performance of 2D Shear Wave Elastography, Transient Elastography and Magnetic Resonance Elastography in Comparison to HistopathologyJon Nielsen0Mette Skalshøi Kjær1Allan Rasmussen2Deepthi Chiranth3Gro Linno Willemoe4Birthe Merete Henriksen5Lotte Borgwardt6Mia Klinten Grand7Lise Borgwardt8Vibeke Brix Christensen9Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Medical Gastroenterology and Hepatology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Surgical Gastroenterology and Transplantation, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Pathology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Pathology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Biostatistics, Faculty of Health Sciences, Institute of Public Health, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, DenmarkDepartment of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark<i>Background</i>: 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. <i>Objectives</i>: 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. <i>Methods:</i> 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. <i>Results</i>: 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. <i>Conclusions</i>: 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.https://www.mdpi.com/2075-4418/12/11/2785liver fibrosiselastographypediatric liver diseaseultrasound elastography2D shear wave elastographytransient elastography |
| spellingShingle | Jon Nielsen Mette Skalshøi Kjær Allan Rasmussen Deepthi Chiranth Gro Linno Willemoe Birthe Merete Henriksen Lotte Borgwardt Mia Klinten Grand Lise Borgwardt Vibeke Brix Christensen 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 Diagnostics liver fibrosis elastography pediatric liver disease ultrasound elastography 2D shear wave elastography transient elastography |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | liver fibrosis elastography pediatric liver disease ultrasound elastography 2D shear wave elastography transient elastography |
| url | https://www.mdpi.com/2075-4418/12/11/2785 |
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