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Shear Wave Elastography in the Assessment of Liver Iron Overload in Children With Beta Thalassemia Major
Nurşah Eker1, Rüştü Turkay2, Sevim Özdemir2
1Department of Pediatric Hematology Oncology, Marmara University, Marmara Faculty of Medicine, Istanbul, Turkiye.
Insights
Shear wave elastography (SWE) effectively detects liver changes in pediatric thalassemia major (TM) patients. This ultrasound method is more accessible than MRI T2* for identifying early liver alterations in children with TM.
Area of Science:
- Pediatric Hepatology
- Medical Imaging
- Thalassemia Research
Background:
- Liver fibrosis and iron overload are significant complications in pediatric patients with thalassemia major (TM).
- Accurate assessment of liver status is crucial for managing TM and preventing long-term complications.
- Magnetic Resonance Imaging (MRI) T2* is a standard for assessing liver iron, but newer methods are being explored.
Purpose of the Study:
- To compare liver elastography (SWE) and MRI T2* findings in children with TM.
- To evaluate the utility of SWE in detecting liver changes in pediatric TM patients.
- To compare SWE parameters between TM patients and a healthy control group.
Main Methods:
- Prospective study involving 38 pediatric TM patients and 25 healthy controls.
- Shear wave elastography (SWE) was performed, followed by MRI T2* in TM patients.
- SWE parameters were compared between TM patients (stratified by iron overload) and controls.
Main Results:
- No significant difference in SWE parameters was found across TM patient groups with varying iron overload levels (mild, moderate, severe) by MRI T2*.
- SWE parameters (median, average, standard values) were significantly higher in TM patients compared to healthy controls (P < 0.001).
- MRI T2* showed significantly higher values in TM patients with normal and mild iron overload compared to controls (P < 0.001).
Conclusions:
- Shear wave elastography (SWE) is an effective, accessible, and easily applicable method for detecting early liver changes in pediatric TM patients.
- SWE shows promise as a valuable tool for monitoring liver status in children with thalassemia major.
- This study provides a basis for further research into the role of SWE in managing pediatric TM.
Abstract:
Shear wave elastography (SWE) is an ultrasound method that effectively demonstrates liver fibrosis. This prospective study aimed to compare magnetic resonance imaging T2* and SWE results of the liver in children with thalassemia major (TM). Patients with TM who had regular follow-ups were included. SWE was performed first, followed by MRI T2*. In addition, a healthy control group of the same age group, known to have no liver disease, was recruited. For these participants, only SWE was performed, and their results were compared with the SWE parameters of the TM patients. The study included 38 patients and 25 individuals who made up the control group. The groups with mild, moderate, and severe iron overload according to MRI T2* were compared in terms of SWE with parameters, and no statistically significant difference was found. However, when comparing the SWE parameters between the control group and patients, the median, average, and standard values were found to be statistically significantly higher in the patient group (P < 0.001, P < 0.001, P = 0.026). When comparing MRI T2* results, the median, average, and standard values were found to be statistically significantly higher in the patients with normal and mild iron overload (P < 0.001, P < 0.001, P = 0.033). SWE is an effective, more accessible, and easy-to-apply method for demonstrating early changes in the liver in pediatric patients with TM. This study serves as a guide for more comprehensive studies that may investigate the effect of SWE in this patient group.
