Status: Funded - Open
Shear wave sonoelastography for the noninvasive evaluation of hepatic fibrosis in the pediatric population
Shannon Farmakis, M.D.
BACKGROUND: Pediatric liver disease represents a growing problem given the rise in pediatric obesity, and patients typically require a biopsy of the liver, an invasive test, in order to obtain diagnostic and prognostic information. Few studies have been done to correlate noninvasive methods of evaluating liver disease with the gold standard of liver biopsy to assess accuracy of the noninvasive method.
GAP: With the incidence of pediatric liver disease on the rise, there is an increasing demand for improved noninvasive methods of liver disease evaluation. This study will compare liver biopsy results with the results of shear wave sonoelastography in pediatric patients with liver disease in order to determine the accuracy of the shear wave technology in evaluating stages of liver fibrosis.
HYPOTHESIS: We hypothesize that shear wave sonoelastography measurements will correlate with the histopathologic assessment of liver fibrosis in pediatric patients.
METHODS: The study design will include patients undergoing liver biopsy in order to evaluate their liver disease who will also undergo an abdominal ultrasound with shear wave elastography. The study population consists of patients with known liver disease caused by a wide variety of disease processes who have undergone a liver biopsy and shear wave sonoelastography exam within one month of each other as well as normal patients without liver disease who have undergone a shear wave sonoelastography exam of the liver.
IMPACT: We believe that SWE may represent an accurate, reliable, and noninvasive method of staging liver fibrosis in pediatric patients and may obviate the need for performing liver biopsies in evaluating liver disease. Our study has the potential to accelerate the adoption of this less invasive approach into wide practice within the next 2-3 years as liver ultrasound is already well established in pediatrics, the equipment is present in many centers, and the benefit to avoiding liver biopsy is well recognized.
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Saint Louis University