Comparison of Controlled Attenuation Parameter and Liver Biopsy to Assess Hepatic Steatosis in Pediatric Patients

Abstract

To assess whether the degree of steatosis as determined by controlled attenuation parameter (CAP) measurements correlates with that observed on liver biopsies in a single-center pediatric and young adult cohort. This cross-sectional study included patients undergoing liver biopsy as part of standard clinical care between January 25, 2012, and April 1, 2015, at Boston Children's Hospital. Eligible patients, with a variety of liver diseases, had CAP measurements within 1year of biopsy. CAP values were compared across histologic steatosis grades using ANOVA. Sixty-nine patients (mean age, 16.0±2.9years; 62% male) were studied. CAP measurements were obtained at a median of 1.3months (IQR, 0.5-3.2) after biopsy. Of the 69 subjects, 23 had steatosis on biopsy. Mean CAP value (dB/m) for subjects with no steatosis was 198±37 vs 290±47 for subjects with steatosis (P<.0001). There were statistically significant differences between CAP values in individuals with no steatosis vs mild/moderate steatosis (P<.0001), no steatosis vs marked steatosis (P<.0001), and mild/moderate vs marked steatosis (P=.004). This study demonstrated a difference in CAP between no steatosis and steatosis, and between grades of steatosis. CAP may be a useful noninvasive tool to detect hepatic steatosis in children.