Amy E Lawrence1, Molly Dienhart2, Jennifer N Cooper1, Daniel Lodwick3, Joseph J Lopez4, Bonita Fung5, Sally Smith6, Patrick Warren6, Ethan Mezoff2, Jane Balint2, Peter C Minneci7. 1. Department of Pediatric Surgery and the Research Institute, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH. 2. Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH. 3. Department of Surgery, The Ohio State University College of Medicine, Columbus, OH. 4. Department of Surgery, New York Medical College, Valhalla, NY. 5. Department of Pathology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH. 6. Department of Radiology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH. 7. Department of Pediatric Surgery and the Research Institute, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH. Electronic address: Peter.Minneci@nationwidechildrens.org.
Abstract
PURPOSE: The purpose of the study was to determine the accuracy of acoustic radiation force impulse (ARFI) ultrasound elastography in assessing the degree of liver disease in children with short bowel syndrome (SBS). METHODS: A prospective observational cohort study of patients with SBS who underwent a liver biopsy and ARFI elastography was performed. Mean shear wave speed (SWS) and stage of fibrosis was evaluated using t-tests. Receiver operating characteristic curves (ROC) were generated and the area under the curves (AUC) estimated in order to assess the accuracy of SWS measurements to discriminate between stages of fibrosis. RESULTS: Thirty-seven paired elastography and biopsy samples from 31 patients were included. The median age was 0.6 years, and 61% were male. There was a significant positive correlation between stage of fibrosis and mean SWS (β=0.16 m/s increase per stage, p=<0.001). ROC analysis revealed that mean SWS had good accuracy for discriminating between mild liver fibrosis (F0-F1) and moderate to severe fibrosis (F2-F4) (AUC=0.80, 95% CI 0.65-0.95). In addition, ROC analysis demonstrated that mean SWS can also accurately discriminate between mild to moderate fibrosis (F0-F2) and more severe fibrosis (F3-F4) (AUC=0.84, 95% CI 0.71-0.96). CONCLUSION: ARFI elastography is an accurate, non-invasive method to monitor liver disease in children with SBS. TYPE OF STUDY: Retrospective Cohort Study LEVEL OF EVIDENCE: II.
PURPOSE: The purpose of the study was to determine the accuracy of acoustic radiation force impulse (ARFI) ultrasound elastography in assessing the degree of liver disease in children with short bowel syndrome (SBS). METHODS: A prospective observational cohort study of patients with SBS who underwent a liver biopsy and ARFI elastography was performed. Mean shear wave speed (SWS) and stage of fibrosis was evaluated using t-tests. Receiver operating characteristic curves (ROC) were generated and the area under the curves (AUC) estimated in order to assess the accuracy of SWS measurements to discriminate between stages of fibrosis. RESULTS: Thirty-seven paired elastography and biopsy samples from 31 patients were included. The median age was 0.6 years, and 61% were male. There was a significant positive correlation between stage of fibrosis and mean SWS (β=0.16 m/s increase per stage, p=<0.001). ROC analysis revealed that mean SWS had good accuracy for discriminating between mild liver fibrosis (F0-F1) and moderate to severe fibrosis (F2-F4) (AUC=0.80, 95% CI 0.65-0.95). In addition, ROC analysis demonstrated that mean SWS can also accurately discriminate between mild to moderate fibrosis (F0-F2) and more severe fibrosis (F3-F4) (AUC=0.84, 95% CI 0.71-0.96). CONCLUSION: ARFI elastography is an accurate, non-invasive method to monitor liver disease in children with SBS. TYPE OF STUDY: Retrospective Cohort Study LEVEL OF EVIDENCE: II.
Authors: Konstantinos C Fragkos; María Claudia Picasso Bouroncle; Shankar Kumar; Lucy Caselton; Alex Menys; Alan Bainbridge; Stuart A Taylor; Francisco Torrealdea; Tomoko Kumagai; Simona Di Caro; Farooq Rahman; Jane Macnaughtan; Manil D Chouhan; Shameer Mehta Journal: Nutrients Date: 2020-07-19 Impact factor: 5.717