Yoon HM, et al. - Here, researchers assess interobserver variation and aim to evaluate the impact of the breathing technique on liver stiffness (LS) measurement utilizing real-time two-dimensional shear-wave elastography (2D-SWE) in children. Based on these outcomes, LS measurement evaluated by real-time 2D-SWE in children demonstrated excellent interobserver agreement. Changes in LS values less than 31.8% of the mean LS values may represent the measurement error. The free-breathing technique demonstrated lower LS values, compared to the breath-holding technique.

Methods

• In this study, they incorporated patients who underwent real-time 2D-SWE by two operators (group 1) and patients who underwent real-time 2D-SWE by one operator utilizing the free-breathing and breath-holding techniques (group 2).
• In group 1, interobserver agreement was evaluated utilizing the intraclass correlation coefficient (ICC) and the 95% limits-of-agreement was examined to assess the maximum change in the LS values based on the Bland-Altman analysis.
• In group 2, the Bland-Altman plot and the paired t-test were utilized to ascertain the impact of breathing technique on LS measurement.

Results

• The current study showed that the interobserver agreement of the LS measurement in group 1 (n=63) was excellent (ICC, 0.953), and the 95% limits-of-agreement was 31.8% of the mean LS values.
• In group 2 (n=45), the free-breathing technique uncovered systematically lower LS with a mean difference of -11.1% of the mean LS values, compared to the breath-holding technique (P=0.016).