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Updated: Jun 23, 2026
Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
Published on: August 29, 2025
[Value of transient elastography in noninvasive assessment in children's hepatic fibrosis]
E Breton1, L Bridoux-Henno, D Guyader
1Unité des nourrissons et explorations fonctionnelles digestives, pôle médicochirurgical de pédiatrie et de génétique clinique, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France. estelle.breton@chu-rennes.fr
Insights
Transient elastography (FibroScan) is a feasible method for assessing liver stiffness in children with liver diseases. This noninvasive technique shows good agreement with pathological studies and can help identify significant liver fibrosis.
Area of Science:
- Pediatric Hepatology
- Noninvasive Diagnostic Techniques
- Liver Fibrosis Assessment
Context:
- Liver fibrosis assessment in children is crucial for managing chronic liver diseases.
- Traditional methods like liver biopsy can be invasive and challenging in pediatric populations.
- Transient elastography (FibroScan) offers a noninvasive alternative for measuring liver stiffness.
Purpose:
- To evaluate the feasibility and reliability of transient elastography (FibroScan) for measuring liver stiffness in pediatric patients.
- To assess the correlation between liver stiffness measurements and the presence of liver fibrosis and portal hypertension in children.
- To compare FibroScan results with pathological findings and the APRI score.
Summary:
- Liver stiffness measurements using FibroScan were performed on 72 children (4-18 years) with various liver diseases.
- FibroScan demonstrated good agreement with liver biopsy results (weighted kappa=0.814).
- Higher liver stiffness was observed in children with portal hypertension (26.5kPa vs 6.4kPa; p<0.01), and the APRI score indicated significant fibrosis in 6/9 of these patients.
Impact:
- Transient elastography is a feasible and reliable method for assessing liver fibrosis in children.
- FibroScan can aid in the noninvasive diagnosis and management of pediatric liver diseases.
- Further large-scale prospective studies are warranted to validate the FibroScan method in pediatric populations.
Aim:
Transient elastography (FibroScan) is a novel, noninvasive, rapid bedside method to assess liver fibrosis by measuring liver stiffness. This study aimed to determine the feasibility and reliability of liver stiffness measurement in children with liver diseases.
Patients And Methods:
Liver stiffness measurements were carried out on 72 children, from 4 to 18 years of age, with potential hepatic fibrosis disease. The clinical, biological, ultrasonographic, and endoscopic parameters were noted to identify children with portal hypertension syndrome. The APRI (ASAT-to-platelet ratio index) test was calculated according to the standard formula. An APRI test score higher than 1.5 indicates significant hepatic fibrosis. METAVIR scoring from 14 liver biopsies was compared to the liver stiffness using the Kappa statistic.
Results:
Twenty-eight patients had viral hepatitis, 20 cystic fibrosis, 16 chronic liver cholestasis, 5 autoimmune hepatitis, and 3 patients had liver fibrosis with uncertain etiology. FibroScan measurements were available in all children. There was good agreement between FibroScan and pathological studies (weighted kappa=0.814). Only 9 children had portal hypertension syndrome with an average measurement of liver stiffness significantly higher than children without portal hypertension (26.5kPa vs 6.4kPa; p<0.01). The APRI test for 6 out of 9 patients scored higher than 1.5.
Conclusion:
These results indicate that liver stiffness measurement is feasible in children and seems to be related to liver fibrosis. Larger prospective studies are needed to validate this FibroScan method.
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