Elastography for Pediatric Chronic Liver Disease: A Review and Expert Opinion
Giovanna Ferraioli1, Richard G Barr2, Jonathan R Dillman3
1Ultrasound Unit, Department of Clinical Sciences and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
Insights
Shear wave elastography (SWE) shows promise for assessing pediatric chronic liver diseases, offering an alternative to liver biopsy. This review explores its use and provides expert guidance for children.
Area of Science:
- Hepatology
- Medical Imaging
- Pediatric Gastroenterology
Background:
- Liver biopsy is invasive and has limitations for pediatric chronic liver diseases.
- Ultrasound and magnetic resonance shear wave elastography (SWE) are established in adults for liver disease assessment.
- Limited data and guidelines exist for SWE in the pediatric population.
Purpose of the Study:
- To review the current literature on the application of SWE in pediatric chronic liver diseases.
- To provide expert recommendations for utilizing ultrasound and magnetic resonance SWE in children.
- To address the gap in guidelines for SWE in pediatric liver conditions.
Main Methods:
- Comprehensive literature search of studies using SWE for pediatric chronic liver diseases.
- Analysis of available data on ultrasound and magnetic resonance SWE techniques in children.
- Synthesis of findings to formulate expert opinions and practical recommendations.
Main Results:
- Ultrasound and magnetic resonance SWE show potential for non-invasively assessing liver stiffness in pediatric patients.
- Evidence suggests SWE can be a valuable tool in managing pediatric chronic liver diseases.
- Further research is needed to establish standardized protocols and expand its clinical use in children.
Conclusions:
- SWE offers a promising, less invasive alternative to liver biopsy for diagnosing and monitoring pediatric chronic liver diseases.
- Expert guidance is crucial for the appropriate application of SWE techniques in pediatric hepatology.
- Continued research and guideline development are essential to optimize SWE use in children with liver conditions.
Abstract:
In adults with chronic liver diseases, ultrasound and magnetic resonance shear wave elastography (SWE) can replace liver biopsy in several clinical scenarios. Several guidelines on the use of ultrasound SWE for the adult population have been published. However, the number of publications in the pediatric population is limited, and available guidelines on SWE do not specifically address pediatric chronic liver diseases. In this article, we review the literature on the use of SWE for pediatric chronic liver diseases and provide expert opinion on how to use SWE, both ultrasound and magnetic resonance techniques, in the pediatric population.
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