Liver stiffness measurement in children using FibroScan: feasibility study and comparison with Fibrotest, aspartate transaminase to platelets ratio index, and liver biopsy.
OBJECTIVE
Transient elastography (FibroScan) is a novel, noninvasive, rapid bedside method to assess liver fibrosis by measuring liver stiffness in adult patients. The usefulness of FibroScan in children with chronic liver diseases is unknown. The aim of this prospective study was to evaluate the feasibility of liver stiffness measurement and to compare FibroScan, Fibrotest, and aspartate transaminase to platelets ratio index (APRI) with liver biopsy for the diagnosis of cirrhosis in children with chronic liver diseases.


METHODS
Between February 2004 and October 2005, 116 consecutive children with chronic liver diseases were prospectively included. All except 1 child (58 boys, mean age 10.7 years) could have noninvasive tests for fibrosis: FibroScan, Fibrotest, and APRI, and, when necessary, a liver biopsy (n = 33).


RESULTS
FibroScan, Fibrotest, and APRI were correlated with clinical or biological parameters of chronic liver diseases, but the FibroScan marker correlated most with all parameters. By histology, the METAVIR fibrosis category score was F1 in 7 cases, F2 in 8 cases, F3 in 6 cases, and F4 in 12 cases. FibroScan, Fibrotest, and APRI were significantly correlated with the METAVIR fibrosis score. For the diagnosis of cirrhosis, the area under the receiver operating characteristic curve was 0.88, 0.73, and 0.73 for FibroScan, Fibrotest, and APRI, respectively.


CONCLUSIONS
These results indicate that liver stiffness measurement is feasible in children and is related to liver fibrosis. A specific probe dedicated to children and slender patients has thus been developed and is currently under evaluation. The FibroScan equipped with this specific probe could become a useful tool for the management of chronic liver diseases in children.
de Lédinghen
Victor
V
INSERM, Université Victor Segalen Bordeaux 2, Bordeaux, France. victor.deledinghen@chu-bordeaux.fr
Le Bail
Brigitte
B
Rebouissoux
Laurent
L
Fournier
Céline
C
Foucher
Juliette
J
Miette
Véronique
V
Castéra
Laurent
L
Sandrin
Laurent
L
Merrouche
Wassil
W
Lavrand
Frédéric
F
Lamireau
Thierry
T
D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D001706:Biopsy; D001792:Blood Platelets / Q000201:enzymology; D002648:Child; D054459:Elasticity Imaging Techniques / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D005355:Fibrosis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis*; D008107:Liver Diseases / Q000150:complications; D008297:Male; D010976:Platelet Count; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers; D001219:Aspartate Aminotransferases