Non-invasive liver fibrosis assessment in children: Two Dimensional Shear Wave Elastography and point Shear Wave Elastography

Aim: To compare the feasibility and performance of two elastographic methods involving ultrasound shear waves in children: two dimensional shear wave elastography (2D-SWE) and point shear wave elastography (point SWE).

Material & methods: We conducted a prospective study in children. Elastographic measurements of liver stiffness were performed using point SWE – Virtual Touch Tissue Quantification (VTQ) (Acuson S2000 Siemens) and 2D-SWE.GE (Logiq E9, GE Healthcare, Chalfont St Giles- UK). Reliable measurements were defined as a median value of 10 liver stiffness measurements with a success rate ≥60% and an interquartile range interval < 30%. Our study population consisted of 30 children (mean age 11.4 ± 3.9, 23.3% girls, mean BMI 22.53 ± 7.3 kg/m²) divided into 3 groups: obese (n = 13), children with hepatopathies (cystic fibrosis associated liver disease, chronic autoimmune hepatitis, n = 4) and a group of normal weight children without liver disease (n = 13).

Results: We obtained a high percentage of reliable measurements when using both VTQ and 2D-SWE GE (90%). We found no significant differences between VTQ and 2D-SWE GE (1.3 ± 0.51 m/s vs. 1.17 ± 0.18 m/s, p = 0.8) in our study population. No significant differences were found between VTQ and 2D-SWE GE across study groups, as well: obese (1.36 ± 0.67 m/s vs. 1.19 ± 0.16, p = 0.8), children with hepatopathies (1.5 ± 0.02 m/s vs. 1.3 ± 0.11 m/s, p = 0.1) and normal weight children without liver disease (1.11 ± 0.15 m/s vs. 1.11 ± 0.19 m/s, p = 0.7).

Conclusion: Both VTQ and 2D-SWE GE performed excellent in obtaining reliable measurements of liver fibrosis in children. Similar values were obtained when using either VTQ or 2D-SWE GE, even in obese and children with hepatopathies.