AM Banc-Husu, LM Bass. JPGN 2021; 73: 141-144. Transient Elastography in Pediatric Liver Disease

This useful review explains the techniques/technologies/limitations of transient elastography and provides pediatric values which correlate with liver fibrosis. Confounding factors, however, may affect elastography measurements, such as obesity, severe inflammation, nonfasting state, and hepatic congestion.

From Table 2 for Elastography (FibroScan technology) Cut-Off Values and Correlation with Outcomes :

• Biliary Atresia: >15.5 kPa distinguishes METAVIR F4 fibrosis and >12.7 kPa predicts development of varices
• Any Chronic Liver disease: >10.6 kPa distinguishes METAVIR F2 fibrosis
• Non-alcoholic fatty liver disease: >9 kPa distinguishes advanced fibrosis
• Portal hypertension: >9.7 kPa distinguishes presence of portal hypertension
• Liver transplant graft: >5.6 kPa distinguishes advanced fibrosis

My take: Elastography is most useful when values are at the very low and very high end. Low values provide a lot of reassurance against significant fibrosis and high values indicate a high likelihood of significant liver fibrosis.

Related blog post:

• Elastography-Accuracy in Children (great picture of Lake Moraine)
• Defining the role for elastography