Title: Doppler ultrasound and 2D Shear wave ultrasound elastography for liver fibrosis
evaluation in Fontan-associated liver disease
Version: 1 Date: 04 Jun 2025
Reviewer's report:
This study evaluated the diagnostic performance of Doppler ultrasound and 2D-SWE in
assessing hepatic fibrosis in Fontan patients and compared the findings with biopsy-proven
fibrosis severity
- The authors tackle an important and very interesting subject. The manuscript is well written.
Congratulations to the authors!
- Please write out first APRI, FIB-4, and RI as it is the 1st time these abbreviations are introduced
into the text
- in the introduction please specify what Doppler ultrasound is of? I believe you mean it to be
of the hepatic artery and the portal vein
- The binary classification of fibrosis is useful to augment the findings in a relatively small
sample size
- Can the authors please hypothesize why hepatic arterial Doppler was a target for investigation
for looking at fibrosis or cirrhosis? This can be outlined best in the introduction.
- For the liver elastography data between the significant and non-significant fibrosis groups,
were there any outliers? Were higher tertile for example more likely yo have fibrosis/cirrhosis?
- Do the authors have any longitudinal data on the ARFI? Was there much variation in values
over time in any one individual?
- Please correct the grammar of this sentence in the discussion section:"However, our study
could not show statistic significant. " should be did not show statistical significance...
- In the discussion section:"When hepatic fibrosis progresses and presence of porta hypertension
" should say portal and not "porta"
* We believe that using PVV in classified non-cirrhosis or cirrhosis group are challenges.  Should
read "are challenging
- It is not clear from the results data presented how Doppler aids the clinical parameters or the
liver stiffness in the more accurate identification of  advanced fibrosis/cirrhosis. Please can the
authors give data in the results section to support this observation
Title: Doppler ultrasound and 2D Shear wave ultrasound elastography for liver fibrosis
evaluation in Fontan-associated liver disease
Version: 1 Date: 04 Jun 2025
Reviewer's report:
This study evaluated the diagnostic performance of Doppler ultrasound and 2D-SWE in
assessing hepatic fibrosis in Fontan patients and compared the findings with biopsy-proven
fibrosis severity
- The authors tackle an important and very interesting subject. The manuscript is well written.
Congratulations to the authors!
- Please write out first APRI, FIB-4, and RI as it is the 1st time these abbreviations are introduced
into the text
- in the introduction please specify what Doppler ultrasound is of? I believe you mean it to be
of the hepatic artery and the portal vein
- The binary classification of fibrosis is useful to augment the findings in a relatively small
sample size
- Can the authors please hypothesize why hepatic arterial Doppler was a target for investigation
for looking at fibrosis or cirrhosis? This can be outlined best in the introduction.
- For the liver elastography data between the significant and non-significant fibrosis groups,
were there any outliers? Were higher tertile for example more likely yo have fibrosis/cirrhosis?
- Do the authors have any longitudinal data on the ARFI? Was there much variation in values
over time in any one individual?
- Please correct the grammar of this sentence in the discussion section:"However, our study
could not show statistic significant. " should be did not show statistical significance...
- In the discussion section:"When hepatic fibrosis progresses and presence of porta hypertension
" should say portal and not "porta"
* We believe that using PVV in classified non-cirrhosis or cirrhosis group are challenges.  Should
read "are challenging
- It is not clear from the results data presented how Doppler aids the clinical parameters or the
liver stiffness in the more accurate identification of  advanced fibrosis/cirrhosis. Please can the
authors give data in the results section to support this observation
Please review this paper.
user
Title: Doppler ultrasound and 2D Shear wave ultrasound elastography for liver fibrosis
evaluation in Fontan-associated liver disease
Version: 1 Date: 04 Jun 2025
Reviewer's report:
This study evaluated the diagnostic performance of Doppler ultrasound and 2D-SWE in
assessing hepatic fibrosis in Fontan patients and compared the findings with biopsy-proven
fibrosis severity
- The authors tackle an important and very interesting subject. The manuscript is well written.
Congratulations to the authors!
- Please write out first APRI, FIB-4, and RI as it is the 1st time these abbreviations are introduced
into the text
- in the introduction please specify what Doppler ultrasound is of? I believe you mean it to be
of the hepatic artery and the portal vein
- The binary classification of fibrosis is useful to augment the findings in a relatively small
sample size
- Can the authors please hypothesize why hepatic arterial Doppler was a target for investigation
for looking at fibrosis or cirrhosis? This can be outlined best in the introduction.
- For the liver elastography data between the significant and non-significant fibrosis groups,
were there any outliers? Were higher tertile for example more likely yo have fibrosis/cirrhosis?
- Do the authors have any longitudinal data on the ARFI? Was there much variation in values
over time in any one individual?
- Please correct the grammar of this sentence in the discussion section:"However, our study
could not show statistic significant. " should be did not show statistical significance...
- In the discussion section:"When hepatic fibrosis progresses and presence of porta hypertension
" should say portal and not "porta"
* We believe that using PVV in classified non-cirrhosis or cirrhosis group are challenges.  Should
read "are challenging
- It is not clear from the results data presented how Doppler aids the clinical parameters or the
liver stiffness in the more accurate identification of  advanced fibrosis/cirrhosis. Please can the
authors give data in the results section to support this observation
assistant