Optimal Acquisition Number for Hepatic Shear Wave Velocity Measurements in Children
Hyun Joo Shin1, Myung-Joon Kim1, Ha Yan Kim2
1Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Seoul, Korea.
Insights
For children over 6 years old, three hepatic shear wave velocity (SWV) measurements using ultrasound elastography are sufficient, regardless of breathing or liver condition. Younger children under 5 may require more measurements during free breathing.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Hepatology
Background:
- Ultrasound elastography is crucial for assessing liver health in children.
- Determining the optimal number of measurements for reliable hepatic shear wave velocity (SWV) data in pediatric populations is essential for accurate diagnosis.
Purpose of the Study:
- To establish the minimum number of hepatic SWV acquisitions needed for reliable ultrasound elastography in children.
- To compare the accuracy of fewer SWV measurements against a larger dataset.
Main Methods:
- Prospective study involving hepatic supersonic shear wave elastography in 88 children across four age and condition groups.
- Measurements were taken during free breathing (FB) and breath holding (BH) if possible.
- Mean SWVs from 3, 5, and 7 acquisitions were compared to 15 measurements using intraclass correlation coefficients (ICC).
Main Results:
- For all children combined, 3, 5, and 7 SWV acquisitions showed almost perfect agreement with 15 acquisitions in both FB and BH statuses (ICC > 0.93).
- Three measurements demonstrated almost perfect agreement in children aged 6-18 years and those with previous Kasai operation during FB.
- A strong agreement was noted for children aged 0-5 years with three measurements during FB (ICC 0.675).
Conclusions:
- Three hepatic SWV acquisitions are sufficient for children over 6 years old, irrespective of breathing status or liver pathology.
- For children under 5 years old, more than three SWV acquisitions are recommended, particularly during free breathing.
- This study provides guidance on optimizing ultrasound elastography protocols for pediatric liver assessment.
Objective:
To investigate the minimum optimal acquisition number of hepatic shear wave velocities (SWVs) on ultrasound elastography in children.
Materials And Methods:
We prospectively performed hepatic supersonic shear wave elastography in children of four groups (group A-C, healthy children, group A with 0-5 years old; group B with 6-10 years old; group C with 11-18 years old; and group D, children with previous Kasai operation) with free breathing (FB) and breath holding (BH) status, if possible. SWVs were measured fifteen times for each child at a 4 cm depth for the right lobe using a 1-6 MHz convex transducer. Mean SWVs from three, five, and seven acquisitions were compared to the mean SWV from fifteen measurements, using an intraclass correlation coefficient (ICC) analyzed with the 1,000 times bootstrap method.
Results:
Total eighty-eight children were included (25 children in group A, 30 children in group B, 21 children in group C, and 12 children in group D). The mean SWVs from fifteen measurements in FB status were 5.5 ± 1.3 kPa for groups A-C together and 8.0 ± 2.2 kPa for group D. For all groups together, mean SWVs from the three (ICC 0.944 and 0.937), five (ICC 0.958 and 0.938) and seven (ICC 0.969 and 0.941) acquisitions demonstrated almost perfect agreement with the reference of fifteen acquisitions in both FB and BH status, respectively. A subgroup analysis showed three measurements were in almost perfect agreement during FB for groups B-D and strong agreement (ICC 0.675) for group A.
Conclusion:
Three acquisitions can be enough for hepatic SWVs in children more than 6 years old regardless of breathing status or hepatic pathology. More acquisitions are recommended for children under the age of 5 years during FB.
