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Updated: May 31, 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
Transient elastography for assessment of fibrosis in paediatric liver disease
Valerio Nobili1, Lidia Monti, Anna Alisi
1Liver Unit, Research Institute, Bambino Gesù Children's Hospital, Piazza S Onofrio 4, 00165 Rome, Italy. nobili66@yahoo.it
Insights
Transient elastography (TE) offers a noninvasive method to assess liver fibrosis in children, improving diagnosis and management of chronic liver diseases. This technique aids in staging fibrosis, guiding therapy, and monitoring disease progression effectively.
Area of Science:
- Pediatric Hepatology
- Medical Imaging
- Fibrosis Assessment
Background:
- Chronic liver diseases in children are managed based on liver fibrosis extent.
- Liver biopsy, the gold standard, is invasive and has limitations.
- Noninvasive methods are crucial for accurate fibrosis assessment in pediatric patients.
Purpose of the Study:
- To review liver fibrosis in pediatric liver diseases.
- To discuss noninvasive techniques for fibrosis diagnosis and follow-up.
- To highlight the role of transient elastography (TE) in assessing pediatric liver fibrosis.
Main Methods:
- Review of existing literature on pediatric liver fibrosis.
- Focus on noninvasive diagnostic and follow-up techniques.
- Detailed examination of transient elastography (TE) characteristics and studies in children.
Main Results:
- Transient elastography (TE) is an accurate and reproducible method.
- TE can identify subjects without fibrosis, with significant fibrosis, or advanced fibrosis.
- TE shows significant strength in assessing liver fibrosis in pediatric populations.
Conclusions:
- Noninvasive methods like TE are vital for managing pediatric chronic liver diseases.
- TE provides a reliable alternative to liver biopsy for fibrosis staging.
- Transient elastography enhances the risk/benefit ratio for fibrosis assessment in children.
Abstract:
The prognosis and management of chronic liver diseases in children largely depend on the extent and progression of liver fibrosis, which is often the most important predictor of disease outcome, and thus influences the indication for potential therapy. Unfortunately, liver biopsy continues to be the gold standard for the staging and grading of fibrosis. Liver biopsy is an invasive and painful technique with several limitations. These limitations have led to the development of alternative noninvasive methods for the accurate assessment of fibrosis and for the maintenance of an acceptable risk/benefit ratio. In the last decades, transient elastography (TE) has received increasing consideration as a means of evaluating disease progression in paediatric chronic liver disease. TE is an accurate and reproducible methodology for identifying subjects without fibrosis or significant fibrosis, or with advanced fibrosis. In this review, we provide an outline of liver fibrosis in paediatric liver diseases, including fibrogenesis, and noninvasive techniques for the diagnosis and follow-up of fibrosis, and then focus on the characteristics of TE and on its strength in the assessment of liver fibrosis, paying particular attention to studies conducted in children.
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