FibroScan is able to predict the severity of liver fibrosis and steatosis in a relatively small cohort of children with liver disease, according to a study published in Hepatology Communications. 

Most often, biopsy from liver fibrosis for staging is typically carried out via percutaneous liver biopsy, followed by liver histology assessment. Errors can occur, however, because the sample selected might have been too small or physicians underestimate or overestimate the extent of liver fibrosis. 

Noninvasive tools such as vibration-controlled transient elastography have been used to record liver stiffness. Despite its relative success in adult patients, very few liver histology fibrosis stagings among children have been carried out using this method. Most children with liver disease are instead staged using FibroScan. 

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The authors of the study wanted to assess its reliability in staging liver disease and its ability to predict significant liver disease in children with nonalcoholic fatty liver disease (NAFLD).

The research team enrolled both prospective and retrospective patients from April 2018 to May 2021 from the Children’s Hospital Colorado. While retrospective participants were chosen from the 1000 clinical FibroScans obtained, prospective participants agreed to fast for 4 hours or more before the FibroScan. Percutaneous liver biopsies were performed based on existing clinical guidelines. There were 206 participants; 116 had NAFLD and 90 did not have NAFLD. Among the 90 participants with NAFLD, two had Alagille syndrome.

Read more about Alagille syndrome etiology

“We found that FibroScan [liver stiffness measurement] significantly correlated with Ishak stages and that [the liver stiffness measurement] adequately discriminated between low and high Ishak stages,” the researchers wrote. 

In addition, the FibroScan controlled attenuation parameters correlated strongly with the grade of steatosis, and the controlled attenuation parameters had an incredible ability to discriminate between patients who had no steatosis vs patients who had steatosis grades 1 to 3. 

“This study encompasses one of the largest pediatric cohorts describing the accuracy of FibroScan [liver stiffness measurement] and [controlled attenuation parameters] to predict liver histologic fibrosis stage and steatosis grade,” they said.


Chaidez A, Pan Z, Sundaram SS, et al. The discriminatory ability of FibroScan liver stiffness measurement, controlled attenuation parameter, and FibroScan–aspartate aminotransferase to predict severity of liver disease in children. Heptol Commun. Published online September 7, 2022. doi:10.1002/hep4.1983