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Hepatic shear wave elastography in children under free-breathing and breath-hold conditions

  • Ultrasound
  • Published:
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Abstract

Objectives

To compare hepatic 2D shear wave elastography (2D SWE) in children between free-breathing and breath-hold conditions, in terms of measurement agreement and time expenditure.

Methods

A cohort of 57 children (12.7±4.3 years) who underwent standardized 2D SWE between May and October 2015 were retrospectively evaluated. Liver elastograms were obtained under free-breathing and breath-hold conditions and time expenditure was measured. Median stiffness, interquartile range (IQR), and IQR/median ratio were calculated based on 12, six, and three elastograms. Results were compared using Pearson correlation coefficient, intraclass correlation coefficient (ICC), Bland-Altman analysis, and Student’s t.

Results

Median liver stiffness under free-breathing and breath-hold conditions correlated strongly (7.22±4.5kPa vs. 7.21±4.11kPa; r=0.97, P<0.001). Time to acquire 12 elastograms with free-breathing was lower than that with breath-holding (79.3±32.5sec vs. 143.7±51.8sec, P<0.001). Results for median liver stiffness based of 12, six, and three elastograms demonstrated very high agreement for free-breathing (ICC 0.993) and for breath-hold conditions (ICC 0.994).

Conclusions

Hepatic 2D SWE performed with free-breathing yields results similar to the breath-hold condition. With a substantially lower time requirement, which can be further reduced by lowering the number of elastograms, the free-breathing technique may be suitable for infants and less cooperative children not capable of breath-holding.

Key Points

• Hepatic 2D SWE performed with free-breathing yields results similar to breath-hold condition.

• Benefit of the free-breathing approach is the substantially lower time requirement.

• Lowering the number of elastograms can further reduce time expenditure.

• Free-breathing 2D SWE is suitable in children with suspected liver disease.

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Abbreviations

2D SWE:

Two dimensional shear wave elastography

ICC:

Intraclass correlation coefficient

IQR:

Interquartile range

SD:

Standard deviation

MRI:

Magnetic resonance imaging

ROI:

Region of interest

TE:

Transient elastography

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany

    Caroline Jung, Anna Hammel & Gerhard Adam

  2. Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany

    Michael Groth, Jasmin Busch & Jochen Herrmann

  3. Section for Addiction Research and Therapy, University Department for Psychiatry and Psychotherapy, 72076, Tübingen, Germany

    Kay Uwe Petersen

  4. Department of Pediatric Gastroenterology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany

    Florian Brinkert & Enke Grabhorn

  5. Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany

    Sören Alexander Weidemann

Authors
  1. Caroline Jung
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  2. Michael Groth
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  4. Anna Hammel
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  10. Jochen Herrmann
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Corresponding author

Correspondence to Jochen Herrmann.

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Guarantor

The scientific guarantor of this publication is PD Dr. med Jochen Herrmann.

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The authors of this manuscript declare no relationships with any companies, that have products or services may be related to the subject matter of the article.

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The authors state that this work has not received any funding.

Statistics and biometry

One of the authors has significant statistical expertise.

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Institutional Review Board approval was obtained.

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Written informed consent was waived by the Institutional Review Board.

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• performed at one institution

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Jung, C., Groth, M., Petersen, K.U. et al. Hepatic shear wave elastography in children under free-breathing and breath-hold conditions. Eur Radiol 27, 5337–5343 (2017). https://doi.org/10.1007/s00330-017-4909-6

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  • DOI: https://doi.org/10.1007/s00330-017-4909-6

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