title: Comparison of Controlled Attenuation Parameter and Liver Biopsy to Assess Hepatic Steatosis in Pediatric Patients.
abstract: To assess whether the degree of steatosis as determined by controlled attenuation parameter (CAP) measurements correlates with that observed on liver biopsies in a single-center pediatric and young adult cohort.
  
  
  
  This cross-sectional study included patients undergoing liver biopsy as part of standard clinical care between January 25, 2012, and April 1, 2015, at Boston Children's Hospital. Eligible patients, with a variety of liver diseases, had CAP measurements within 1 year of biopsy. CAP values were compared across histologic steatosis grades using ANOVA.
  
  
  
  Sixty-nine patients (mean age, 16.0 ± 2.9 years; 62% male) were studied. CAP measurements were obtained at a median of 1.3 months (IQR, 0.5-3.2) after biopsy. Of the 69 subjects, 23 had steatosis on biopsy. Mean CAP value (dB/m) for subjects with no steatosis was 198 ± 37 vs 290 ± 47 for subjects with steatosis (P < .0001). There were statistically significant differences between CAP values in individuals with no steatosis vs mild/moderate steatosis (P < .0001), no steatosis vs marked steatosis (P < .0001), and mild/moderate vs marked steatosis (P = .004).
  
  
  
  This study demonstrated a difference in CAP between no steatosis and steatosis, and between grades of steatosis. CAP may be a useful noninvasive tool to detect hepatic steatosis in children.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA. Electronic address: Nirav.desai@childrens.harvard.edu.
authors.forename: Nirav K
authors.initials: NK
authors.lastname: Desai
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Harney
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA.
authors.forename: Roshan
authors.initials: R
authors.lastname: Raza
authors.affiliation: Department of Pathology, Boston Children's Hospital, Boston, MA.
authors.forename: Alyaa
authors.initials: A
authors.lastname: Al-Ibraheemi
authors.affiliation: Department of Pathology, Boston Children's Hospital, Boston, MA.
authors.forename: Nick
authors.initials: N
authors.lastname: Shillingford
authors.affiliation: Clinical Research Center, Boston Children's Hospital, Boston, MA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Mitchell
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA.
authors.forename: Maureen M
authors.initials: MM
authors.lastname: Jonas
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques; D005234:Fatty Liver / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: NAFLD; child; elastography; fatty liver; liver disease; non-alcoholic fatty liver disease