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CC BY 4.0 · Journal of Child Science 2021; 11(01): e55-e59
DOI: 10.1055/s-0041-1725079
Research Article

Diagnostic Performance of Noninvasive Methods for Liver Biopsy by Fibroscan in Pediatric

Ghobad Heidari 
1   Department of Pediatric, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
,
Farzaneh Motamed‡   *
2   Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
,
Bita Heirati
3   Department of Pediatric, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
,
Parisa Rahmani    *
2   Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Funding None.
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Abstract

Liver biopsy is the gold standard for the diagnosis and management of various liver diseases; however, noninvasive diagnostic modalities may help prevent adverse effects of anesthesia, prolonged hospitalization, sampling error, and other serious complications, particularly in pediatric patients. The aim of this study is to compare the results of liver biopsy and fibroscan in children with chronic liver diseases. All patients presenting chronic liver disease admitted in the ward or clinic of Tehran's Children Medical Center were enrolled in the study. Required laboratory tests were performed to diagnose the disease, followed by elastography using fibroscan 402 (M-probe) Echosens machine and liver biopsy using Menghini technique. Samples were scored by using METAVIR scoring system. Thirty-two patients were reported (68.8%, female) with autoimmune hepatitis (18.8%), Wilson disease (12.5%), and glycogen storage disease (12.5%). The most common pathologic stage and fibroscan result was stage III and F0 (46.9%), respectively. Association between pathology and fibroscan results was not significant. Nonetheless, age and diagnosis, age and Fibroscan score, and pathology and liver function test were significantly associated with each other. Fibroscan cannot be used as an alternative to liver biopsy; however, it can be a useful accessory tool.

Keywords

fibroscan - liver biopsy - elastography - pediatric - Menghini technique - METAVIR scoring

* The authors contributed equally to this work.


Note

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


Authors' Contributions

P.R. and G.H. conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. F.M. designed the data collection instruments, collected data, performed the initial analyses, and reviewed and revised the manuscript. B.H. coordinated and supervised data collection, and critically reviewed the manuscript for important intellectual content.




Publikationsverlauf

Eingereicht: 08. September 2020

Angenommen: 19. Januar 2021

Artikel online veröffentlicht:
25. Februar 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Cassinotto C, Boursier J, de Lédinghen V. et al. Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology 2016; 63 (06) 1817-1827
    CrossrefPubMedSuche in Google Scholar
  • 2 Vos MB, Abrams SH, Barlow SE. et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr 2017; 64 (02) 319-334
    CrossrefPubMedSuche in Google Scholar
  • 3 Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. American Association for the Study of Liver Diseases. Liver biopsy. Hepatology 2009; 49 (03) 1017-1044
    CrossrefPubMedSuche in Google Scholar
  • 4 Lefkowitch JH. Scheuer's Liver Biopsy Interpretation E-Book. Elsevier Health Sciences. 2015
    Suche in Google Scholar
  • 5 Boursier J, Vergniol J, Guillet A. et al. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease. J Hepatol 2016; 65 (03) 570-578
    CrossrefPubMedSuche in Google Scholar
  • 6 Malekzadeh R, Poustchi H. Fibroscan for assessing liver fibrosis: an acceptable alternative for liver biopsy: fibroscan: an acceptable alternative for liver biopsy. Hepat Mon 2011; 11 (03) 157-158
    PubMedSuche in Google Scholar
  • 7 Honar N, Jooya P, Haghighat M. et al. Complications of blind versus ultrasound-guided percutaneous liver biopsy in children. Arab J Gastroenterol 2015; 16 (3-4): 90-93
    CrossrefPubMedSuche in Google Scholar
  • 8 Foucher J, Chanteloup E, Vergniol J. et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut 2006; 55 (03) 403-408
    CrossrefPubMedSuche in Google Scholar
  • 9 Abdelaal UM, Morita E, Nouda S. et al. Evaluation of portal hypertensive enteropathy by scoring with capsule endoscopy: is transient elastography of clinical impact?. J Clin Biochem Nutr 2010; 47 (01) 37-44
    CrossrefPubMedSuche in Google Scholar
  • 10 Trout AT, Sheridan RM, Serai SD. et al. Diagnostic performance of MR elastography for liver fibrosis in children and young adults with a spectrum of liver diseases. Radiology 2018; 287 (03) 824-832
    CrossrefPubMedSuche in Google Scholar
  • 11 Kalaitzakis E. Gastrointestinal dysfunction in liver cirrhosis. World J Gastroenterol 2014; 20 (40) 14686-14695
    CrossrefPubMedSuche in Google Scholar
  • 12 Potretzke TA, Saling LJ, Middleton WD, Robinson KA. Bleeding complications after percutaneous liver biopsy: do subcapsular lesions pose a higher risk?. AJR Am J Roentgenol 2018; 211 (01) 204-210
    CrossrefPubMedSuche in Google Scholar
  • 13 Gamil M, Alboraie M, El-Sayed M. et al. Novel scores combining AFP with non-invasive markers for prediction of liver fibrosis in chronic hepatitis C patients. J Med Virol 2018; 90 (06) 1080-1086
    CrossrefPubMedSuche in Google Scholar
  • 14 Omran AA, Osman KS, Kamel HM, Abdel-Naem EA, Hasan DE. MicroRNA-122 as a novel non-invasive marker of liver fibrosis in hepatitis C virus patients. Clin Lab 2016; 62 (07) 1329-1337
    PubMedSuche in Google Scholar
  • 15 Huang Y, Adams LA, Joseph J, Bulsara MK, Jeffrey GP. The ability of hepascore to predict liver fibrosis in chronic liver disease: a meta-analysis. Liver Int 2017; 37 (01) 121-131
    CrossrefPubMedSuche in Google Scholar
  • 16 Adams LA, Bulsara M, Rossi E. et al. Hepascore: an accurate validated predictor of liver fibrosis in chronic hepatitis C infection. Clin Chem 2005; 51 (10) 1867-1873
    CrossrefPubMedSuche in Google Scholar
  • 17 Siddiqui MS, Vuppalanchi R, Van Natta ML. et al; NASH Clinical Research Network. Vibration-controlled transient elastography to assess fibrosis and steatosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2019; 17 (01) 156-163.e2
    CrossrefPubMedSuche in Google Scholar
  • 18 Zhang X, Wong GL-H, Wong VW-S. Application of transient elastography in nonalcoholic fatty liver disease. Clin Mol Hepatol 2020; 26 (02) 128-141
    CrossrefPubMedSuche in Google Scholar
  • 19 Aqul A, Jonas MM, Harney S. et al. Correlation of transient elastography with severity of cystic fibrosis-related liver disease. J Pediatr Gastroenterol Nutr 2017; 64 (04) 505-511
    CrossrefPubMedSuche in Google Scholar
  • 20 Lewindon PJ, Puertolas-Lopez MV, Ramm LE. et al. Accuracy of transient elastography data combined with APRI in detection and staging of liver disease in pediatric patients with cystic fibrosis. Clin Gastroenterol Hepatol 2019; 17 (12) 2561-2569.e5
    CrossrefPubMedSuche in Google Scholar
  • 21 Fitzpatrick E, Quaglia A, Vimalesvaran S, Basso MS, Dhawan A. Transient elastography is a useful noninvasive tool for the evaluation of fibrosis in paediatric chronic liver disease. J Pediatr Gastroenterol Nutr 2013; 56 (01) 72-76
    CrossrefPubMedSuche in Google Scholar
  • 22 Engelmann G, Gebhardt C, Wenning D. et al. Feasibility study and control values of transient elastography in healthy children. Eur J Pediatr 2012; 171 (02) 353-360
    CrossrefPubMedSuche in Google Scholar
  • 23 Goldschmidt I, Streckenbach C, Dingemann C. et al. Application and limitations of transient liver elastography in children. J Pediatr Gastroenterol Nutr 2013; 57 (01) 109-113
    CrossrefPubMedSuche in Google Scholar
  • 24 Shen Q-L, Chen YJ, Wang ZM. et al. Assessment of liver fibrosis by Fibroscan as compared to liver biopsy in biliary atresia. World J Gastroenterol 2015; 21 (22) 6931-6936
    CrossrefPubMedSuche in Google Scholar
  • 25 Binkovitz LA, El-Youssef M, Glaser KJ, Yin M, Binkovitz AK, Ehman RL. Pediatric MR elastography of hepatic fibrosis: principles, technique and early clinical experience. Pediatr Radiol 2012; 42 (04) 402-409
    CrossrefPubMedSuche in Google Scholar
  • 26 Cho Y, Tokuhara D, Morikawa H. et al. Transient elastography-based liver profiles in a hospital-based pediatric population in Japan. PLoS One 2015; 10 (09) e0137239
    CrossrefPubMedSuche in Google Scholar