Evidence map›Paper›PMID 33759025›Full record

ArticlePediatric radiology2021

Clinical use of shear-wave elastography for detecting liver fibrosis in children and adolescents with cystic fibrosis.

Steven Levitte, Lori W Lee, Jared Isaacson, Evan J Zucker, Carlos Milla, Richard A Barth, Zachary M Sellers

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Ultrasound Elastography in Children.Children (Basel, Switzerland) · 2023
    Review
  5. Article
  6. Review
  7. Review
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Steven LevitteDepartment of Pediatrics, Stanford University, Palo Alto, CA, USA.
Lori W LeeDepartment of Pediatrics, Stanford University, Palo Alto, CA, USA.
Jared IsaacsonDepartment of Pediatric Radiology, Stanford University, Palo Alto, CA, USA.
Evan J ZuckerDepartment of Pediatric Radiology, Stanford University, Palo Alto, CA, USA.
Carlos MillaDepartment of Pediatric Pulmonary Medicine, Stanford University, Palo Alto, CA, USA.
Richard A BarthDepartment of Pediatric Radiology, Stanford University, Palo Alto, CA, USA.
Zachary M SellersDepartment of Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, 750 Welch Road, Suite 116, Palo Alto, CA, 94304, USA. zsellers@stanford.edu.ORCID http://orcid.org/0000-0001-5352-7760
Stanford University · USPalo Alto University · US

Funding

CFTR-Independent Bicarbonate Secretion is a Novel CF Therapeutic TargetK08DK124684 · NIDDK · STANFORD UNIVERSITY · PI SELLERS, ZACHARY MICHAEL · 2020 to 2024
$678k
Cystic Fibrosis Foundation SELLER16L0; SELLER19GE0NIDDK NIH HHS K08 DK124684NIDDK NIH HHS K08DK124684
6 · The paper itself

Abstract

backgroundComplications from liver cirrhosis are a leading cause of death in children with cystic fibrosis. Identifying children at risk for developing liver cirrhosis and halting its progression are critical to reducing liver-associated mortality.

objectiveQuantitative US imaging, such as shear-wave elastography (SWE), might improve the detection of liver fibrosis in children with cystic fibrosis (CF) over gray-scale US alone. We incorporated SWE in our pediatric CF liver disease screening program and evaluated its performance using magnetic resonance (MR) elastography. MATERIALS AND

methodsNinety-four children and adolescents with CF underwent 178 SWE exams, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and platelet measurements. Of these, 27 children underwent 34 MR elastography exams. We evaluated SWE performance using 6-MHz and 9-MHZ point SWE, and 9-MHz two-dimensional (2-D) SWE.

resultsThe 6-MHz point SWE was the only method that correlated with MR elastography (r=0.52; 95% confidence interval [CI] 0.20-0.74; P=0.003). SWE of 1.45 m/s distinguished normal from abnormal MR elastography (79% sensitivity, 100% specificity, 100% positive predictive value [PPV], 55% negative predictive value [NPV], area under the receiver operating characteristic [AUROC] curve 0.94). SWE of 1.84 m/s separated mild-moderate (3.00-4.77 kPa) from severe (>4.77 kPa) MR elastography (88% sensitivity, 86% specificity, 78% PPV, 93% NPV, AUROC 0.79). Elevations of AST, ALT, GGT and thrombocytopenia were associated with higher SWE. AST-to-platelet ratio index of 0.42, fibrosis-4 of 0.29, and GGT-to-platelet ratio of 1.43 all had >95% NPV for SWE >1.84 m/s.

conclusionGiven its correlation with MR elastography, SWE might be a clinically useful predictor of liver fibrosis. We identified imaging criteria delineating the use of SWE to identify increased liver stiffness in children with CF. With multicenter validation, these data might be used to improve the detection and monitoring of liver fibrosis in children with CF.

Indexed as

Cystic FibrosisElasticity Imaging TechniquesLiver DiseasesAdolescentChildHumansLiverLiver CirrhosisAdolescentsChildrenCystic fibrosisCystic fibrosis liver diseaseLiverMagnetic resonance elastographyShear-wave elastographyStiffnessUltrasound

Identifiers

PMID33759025
PMCPMC8823212
OpenAlexW3136744078

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.