{
  "abstract": "Objective Liver biopsy (LB) is considered the test of choice for diagnosing liver fibrosis in children. Although LB provides extensive information, it is an invasive procedure that requires anesthesia and needs to be interpreted by experts to provide reliable information. In recent years, non-invasive tests, including Fibroscan, have been developed to assess liver fibrosis, aiming to reduce the need for LB. This study aimed to evaluate the relationship between Fibroscan measurements and liver biopsy findings in children, and to assess its potential as a reliable alternative.Methods A retrospective study included all children under 18 years old who underwent LB between August 2024 and November 2025 and had a Fibroscan test at King’s College Hospital, with an interval of less than one year between the two assessments.Results Eighty-nine children were included in the study, 50 were males (56.2%), and the median age was 11.5 years (IQR 5.66,14.91). The most common background disease was autoimmune diseases (36, 40.5%), followed by biliary diseases, including biliary atresia (12, 13.5%). Seven children did not have fibrosis in the LB (F0 according to the METAVIR score), 21 had F1, 26 had F2, 15 had F3, and 20 had F4. The median time between the LB and the Fibroscan was two days (IQR 0,108) and average of 56.3 days. There was a significant association between the liver stiffness measure (LSM) and the fibrosis score (6.5, 9.2, 9.2, 17.5, and 29.9 kPa, p-value<0.0002, respectively). There was no significant association between the fibrosis score and transaminases, Gamma-Glutamyl Transferase (GGT), or the AST-to-platelet ratio (APRI). A multivariable analysis showed a significant association between the METAVIR score and LSM, adjusted for the child’s age, background disease, and the interval between the LB and Fibroscan (OR=1.1, 95%CI 1.055-1.147). A ROC analysis was performed, showing a threshold of 5.8 kPa with a sensitivity of 75.6%, a specificity of 71.4% and a positive predictive value of 97% for identifying children with fibrosis.Conclusion There is a significant association between LB and Fibroscan results, especially among patients with more advanced fibrosis (F2 or higher). A larger homogenous cohort study is required to establish a threshold with higher sensitivity and PPV.Abstract LBA15 Table 1Comparison of liver stiffness and biochemical markers by fibrosis stage F0F1F2F3F4PvalueNumber721261520LSM average6.59.39.217.529.9<0.0002AST309.6206.3232.9344.9231.40.4ALT210.1161.6194.4360.2507.20.74Total Bili7.1445.140.831.1410.002Conjugated Bili2044.340.419.527.80.27GGT243.9101.21382172040.15ALP492.7321.9317.47873870.06APRI2.52.62.93.3150.23Heterogenous liver (%)14.331.64840800.0084",
  "authors": [
    {
      "affiliations": [
        "Paediatric Liver, GI & Nutrition Centre, King’s College Hospital, London, UK"
      ],
      "name": "Zuzanna Dulnikiewicz"
    },
    {
      "affiliations": [
        "Paediatric Liver, GI & Nutrition Centre, King’s College Hospital, London, UK"
      ],
      "name": "Raouf Nassar"
    },
    {
      "affiliations": [
        "Paediatric Liver, GI & Nutrition Centre, King’s College Hospital, London, UK"
      ],
      "name": "Hannah Spoor"
    },
    {
      "affiliations": [
        "Paediatric Liver, GI & Nutrition Centre, King’s College Hospital, London, UK"
      ],
      "name": "Caitlin Murphy"
    },
    {
      "affiliations": [
        "Paediatric Liver, GI & Nutrition Centre, King’s College Hospital, London, UK"
      ],
      "name": "Tassos Grammatikopoulos"
    },
    {
      "affiliations": [
        "Paediatric Liver, GI & Nutrition Centre, King’s College Hospital, London, UK"
      ],
      "name": "Alastair Baker"
    },
    {
      "affiliations": [
        "Paediatric Liver, GI & Nutrition Centre, King’s College Hospital, London, UK"
      ],
      "name": "Robert Hegarty"
    }
  ],
  "title": "LBA15 The association between fibroscan and liver biopsy in children",
  "uid": "37b741ef-4151-56e4-807b-1d7f98913550"
}