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Author Spotlight: Advancing Hepatic Fibrosis Diagnosis Using Magnetic Resonance Elastography and AI
Published on: July 21, 2023
MR and Ultrasound Elastography for Fibrosis Assessment in Children: Practical Implementation and Supporting
Suraj D Serai1,2, Stéphanie Franchi-Abella3,4,5, Ali B Syed6
1Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104.
Insights
Quantitative MRI and ultrasound elastography are key noninvasive tools for diagnosing and managing pediatric liver fibrosis. MRI may offer greater accuracy than ultrasound in evaluating liver fibrosis in children.
Area of Science:
- Pediatric Radiology
- Hepatology
- Medical Imaging
Background:
- Quantitative biomarkers for liver fibrosis are crucial for diagnosing and managing pediatric chronic liver disease (CLD).
- MR elastography and ultrasound shear-wave elastography are increasingly replacing liver biopsy for fibrosis assessment in children.
- These noninvasive techniques aid in diagnosis, staging, and treatment monitoring of CLD.
Purpose of the Study:
- To guide the use of MRI- and ultrasound-based elastography for liver fibrosis assessment in pediatric patients.
- To provide practical approaches for adapting and optimizing these elastography methods in children.
- To discuss clinical indications, patient preparation, equipment, acquisition techniques, and potential pitfalls.
Main Methods:
- Review of current literature and clinical practices for MRI and ultrasound elastography in pediatric liver fibrosis.
- Discussion of technical considerations, including patient preparation and acquisition protocols.
- Presentation of case examples for interpretation and reporting guidance.
Main Results:
- Both MRI and ultrasound elastography are valuable noninvasive tools for evaluating pediatric liver fibrosis.
- MRI elastography may provide superior reliability and accuracy compared to ultrasound.
- Ultrasound elastography offers advantages in portability and cost, particularly for young children.
Conclusions:
- MRI- and ultrasound-based elastography are essential for noninvasive liver fibrosis assessment in children.
- Clinicians should consider the strengths and limitations of each modality for optimal patient management.
- This review provides practical guidance for the effective application and interpretation of elastography in pediatric liver disease.
Abstract:
Quantitative MRI and ultrasound biomarkers of liver fibrosis have become important tools in the diagnosis and clinical management of children with chronic liver disease (CLD). In particular, MR elastography is now routinely performed in clinical practice to evaluate the liver for fibrosis. Ultrasound shear-wave elastography has also become widely performed for this purpose, especially in young children. These noninvasive methods are increasingly used to replace liver biopsy for the diagnosis, quantitative staging, and treatment monitoring of patients with CLD. Although ultrasound has the advantages of portability and lower equipment cost than MRI, available evidence indicates that MRI may have greater reliability and accuracy in liver fibrosis evaluation. In this AJR Expert Panel Narrative Review, we describe how, why, and when to use MRI- and ultrasound-based elastography methods for liver fibrosis assessment in children. Practical approaches are discussed for adapting and optimizing these methods in children, with consideration of clinical indications, patient preparation, equipment requirements, and acquisition technique, as well as pitfalls and confounding factors. Guidance is provided for interpretation and reporting, and representative case examples are presented.
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