Poor correlation of 2D shear wave elastography and transient elastography in Fontan‐associated liver disease: A head‐to‐head comparison

Author:

Gill Madeleine123ORCID,Mudaliar Sanjivan1ORCID,Prince David13ORCID,Than Nwe Ni4,Cordina Rachel25,Majumdar Avik267ORCID

Affiliation:

1. Australian National Liver Transplant Unit Royal Prince Alfred Hospital Sydney New South Wales Australia

2. Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia

3. Centenary Institute of Cancer Medicine and Cell Biology Sydney New South Wales Australia

4. Department of Gastroenterology and Hepatology University Hospital Coventry Coventry UK

5. Department of Cardiology Royal Prince Alfred Hospital Sydney New South Wales Australia

6. Victorian Liver Transplant Unit, Austin Hospital Heidelberg Victoria Australia

7. Division of Medicine, Dentistry and Health Science The University of Melbourne Melbourne Victoria Australia

Abstract

AbstractBackground and AimsFontan‐associated liver disease (FALD) is a long‐term complication of the Fontan procedure. Guidelines recommend elastography, but the utility of transient elastography (TE) and two‐dimensional shear wave elastography (2D SWE) is unknown. We aimed to evaluate the relationship between TE and 2D SWE in FALD.MethodsThis prospective cohort study included 25 patients managed in a specialist clinic between January 2018 and August 2021. Trained clinicians performed 2D SWE (GE Logiq‐E9) and TE (FibroScan 503 Touch) on the same day under the same conditions. Laboratory, echocardiography, and imaging data were collected. The atrioventricular systolic‐to‐diastolic duration (AVV S/D ratio) was calculated as a measure of cardiac diastolic function.ResultsWe analyzed 40 paired measurements. Median age was 22 years. Median liver stiffness measurement (LSM) was 15.4 kPa (12.1–19.6) by TE and 8.0 kPa (7.0–10.3) (P = 0.001) by 2D SWE. There was weak correlation between the modalities (r = 0.41, P = 0.004). There was no correlation between time since Fontan and LSM by TE (r = 0.15, P = 0.19) or 2D SWE (r = 0.19, P = 0.13). There was no difference in LSM irrespective of whether sonographic cirrhosis was present or absent by TE (17.4 kPa [15.9–23.6] vs. 14.9 kPa [12.0–19.4], respectively, P = 0.6) or 2D SWE (9.0 kPa [2.8–10.5] vs. 8.0 kPa [6.7–10.1], P = 0.46). There was no correlation between AVV S/D ratio and LSM by TE (r = 0.16, P = 0.18) or 2D SWE (r = 0.02, P = 0.45).ConclusionsIn FALD, TE and 2D SWE are poorly correlated. LSM by either modality was not associated with known risk factors for liver fibrosis or Fontan function. Based on these data, the role of elastography in FALD is uncertain.

Publisher

Wiley

Subject

Gastroenterology,Hepatology

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