ArticlePediatric research2020
Repeatability of transient elastography in children.
Article in Pediatric research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 23 citations in OpenAlex.
- Ultrasound elastography in pediatric care: bridging innovation and noninvasive diagnostics.Italian journal of pediatrics · 2026Review
- Comparative performance of multiple novel obesity indices for MAFLD screening in Chinese children: the body roundness index as a practical predictor.Frontiers in medicine · 2026Article
- Article
- New guidelines for screening, evaluation and management of hepatobiliary disease in cystic fibrosis.Hepatobiliary surgery and nutrition · 2024Article
- Combi-Elasto Evaluation of the Degree of Liver Fibrosis in Children with Cholestatic Liver Disease.Diagnostics (Basel, Switzerland) · 2023Article
- Ultrasound Elastography in Children.Children (Basel, Switzerland) · 2023Review
- Pediatric percentiles for transient elastography measurements - effects of age, sex, weight status and pubertal stage.Frontiers in endocrinology · 2022Article
- Noninvasive Pediatric Liver Fibrosis Measurement: Two-Dimensional Shear Wave Elastography Compared With Transient Elastography.Frontiers in pediatrics · 2022Article
- Rigorous and consistent evaluation of diagnostic tests in children: another unmet need.Pediatric research · 2020Article
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPoorly performing diagnostic tests can impact patient safety. Clinical investigations must have good precision and diagnostic accuracy before widespread use in clinical practice. Transient elastography (TE) measures liver stiffness, a surrogate marker of liver fibrosis in adults and children. Studies to evaluate its repeatability and reproducibility (precision) in children are limited. Our aim was to determine (i) the normal range of TE measurements and (ii) the repeatability and reproducibility of TE in healthy children.
methodsTE was performed in 257 healthy children, of whom 235 (91%, mean age 11.7 years, standard deviation (SD) 2.51, 107 were males (45.5%)) had two valid TE measurements performed, at least 24 h apart, by two operators under similar circumstances. High-quality TE images were obtained for each examination.
resultsThe normal range of TE was 2.88-6.52 kPa. The mean difference between paired measurements was 0.044 (SD 0.4). The 95% limits of agreement ranged from -0.8 to +0.76 kPa for repeat measurements. There was a difference of >1 kPa between measurements in 61/235 (25.9%) children. The lack of precision was similar across all age groups.
conclusionsThis study demonstrates that TE does not have acceptable precision in healthy children, because random measurement variation results in the lack of agreement between paired measurements. IMPACT: The precision and diagnostic accuracy of a new technology must be determined before it is deployed in children in order to ensure that appropriate clinical decisions are made, and healthcare resources are not wasted. TE is widely used to diagnose liver disease in children without adequate evaluation of the precision (repeatability) of TE either in healthy children or children with liver disease. This study demonstrates that TE does not have adequate precision in children. This study was performed in accordance with methods previously published for children. Refinements to the test protocol, such as duration of fasting or probe size, will have to be evaluated for their impact on precision and accuracy before the test is deployed in research studies or clinical practice.
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