Correlation of shear wave elastography with liver biopsy in children with Chronic Liver disease

Background & Objectives: Liver biopsy remains the gold standard for assessment of liver fibrosis; however, it is limited practically because of issues of sampling errors and invasiveness. This opens the way for other important noninvasive processes of diagnosis including the role and utilisation of Shear Wave Elastography in coming years for liver diseases. This post-hoc study will firstly aim to establish the correlation existing between the currently preferred gold standard liver biopsy and 2D-Shear Wave elastography's diagnostic accuracy in paediatric patients presenting with suspected or confirmed liver disease. Methods: This retrospective study was conducted in Pakistan Kidney and Liver Institute and Research Center in Lahore, Pakistan from August 2017 to January 2024. In this analysis, 37 Paediatric patients with various liver diseases who underwent liver biopsy for autoimmune hepatitis, Budd-Chiari syndrome, Wilson disease and other liver-related pathologies were included. Results: Thirty-seven patients with a mean age of 10 years (ranging from 4-14 years) were enrolled. According to this study, sixteen out of thirty seven (43%) cases of chronic liver disease were caused by autoimmune hepatitis. Patients' average liver stiffness as determined by SWE was 12.14 +/- 0.75 kPa. According to elastography, the average liver stiffness in individuals with F0-F1 fibrosis was 6 +/- 0.01 kPa, 7.67 +/- 0.29 in stage F2, 8.62 +/- 0.20 in stage F3, and 14.05 +/- 3.69 kPa in stage F4. We discovered that the mean level of hepatic stiffness varied significantly depending on the degree of fibrosis (p = 0.0001). Conclusion: SWE gauges the liver tissue's stiffness, which rises with fibrosis severity. Research has demonstrated that SWE, which is frequently equivalent to liver biopsy, has a high degree of accuracy in identifying and staging hepatic fibrosis.