Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis

Published on Aug 1, 2018in BMJ Open2.496
· DOI :10.1136/BMJOPEN-2018-021787
Weixi Jiang2
Estimated H-index: 2
(CQMU: Chongqing Medical University),
Sirun Huang2
Estimated H-index: 2
(CQMU: Chongqing Medical University)
+ 4 AuthorsHaitao Ran1
Estimated H-index: 1
(CQMU: Chongqing Medical University)
Sources
Abstract
Objective This study aimed to assess the accuracy of staging liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) usingpoint shear wave elastography (pSWE) and transient elastography (TE). Setting Relevant records on NAFLD were retrieved from PubMed, Embase, Web of Science and the China National Knowledge Infrastructure databases up to 20 December 2017. A bivariate mixed-effects model was conducted to combine sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the summary receiver operating characteristic curve (AUC) between pSWE and TE. A sensitivity analysis was implemented to explore the source of heterogeneity. Participants Patients with NAFLD who had a liver stiffness measurement using pSWE and TE before liver biopsy were enrolled according to the following criteria: 2×2 contingency tables can be calculated via the reported number of cases; sensitivity and specificity were excluded according to the following criteria: history of other hepatic damage, such as chronic hepatitis C, concurrent active hepatitis B infection, autoimmune hepatitis, suspicious drug usage and alcohol abuse. Results Nine pSWE studies comprising a total of 982 patients and 11 TE studies comprising a total of 1753 patients were included. For detection of significant fibrosis, advanced fibrosis and cirrhosis, the summary AUC was 0.86 (95% CI 0.83 to 0.89), 0.94 (95% CI 0.91 to 0.95) and 0.95 (95% CI 0.93 to 0.97) for pSWE, and the summary AUC was 0.85 (95% CI 0.82 to 0.88), 0.92 (95% CI 0.89 to 0.94) and 0.94 (95% CI 0.93 to 0.97) for TE, respectively. The proportion of failure measurement was over tenfold as common with TE using an M probe compared with pSWE. Conclusion pSWE and TE, providing precise non-invasive staging of liver fibrosis in NAFLD, are promising techniques, particularly for advanced fibrosis and cirrhosis.
📖 Papers frequently viewed together
201714.68Hepatology
6 Authors (Guangqin Xiao, ..., Gang Wu)
261 Citations
201814.68Hepatology
161 Citations
245 Citations
References42
Newest
#1Christoph F. Dietrich (Zhengzhou University)H-Index: 74
#2Jeffrey C. Bamber (The Royal Marsden NHS Foundation Trust)H-Index: 59
Last. Maja Thiele (University of Southern Denmark)H-Index: 20
view all 20 authors...
We present here the first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography with a focus on the assessment of diffuse liver disease. The short version provides clinical information about the practical use of elastography equipment and interpretation of results in the assessment of diffuse liver disease and analyzes the main findings based on published studies, stressing the eviden...
397 CitationsSource
#1Nicole C. Harris (Royal Melbourne Hospital)H-Index: 12
#2David Nadebaum (Royal Melbourne Hospital)H-Index: 2
Last. Robert N. Gibson (Royal Melbourne Hospital)H-Index: 23
view all 7 authors...
INTRODUCTION: The accuracy of Acoustic Radiation Force Impulse (ARFI) imaging has been validated in the setting of hepatitis C, however, the accuracy in the setting of fatty liver disease (FLD) has been less well-established. The aim of this study was to assess the accuracy of ARFI in the setting of hepatic steatosis. METHODS: Patients with biopsy proven or sonographically diagnosed liver steatosis were assessed for ARFI trends including: inter-operator concordance, interquartile range, ARFI fai...
10 CitationsSource
#1D Attia (MHH: Hannover Medical School)H-Index: 11
#2Heike Bantel (MHH: Hannover Medical School)H-Index: 36
Last. Andrej Potthoff (MHH: Hannover Medical School)H-Index: 25
view all 6 authors...
SummaryBackground Obesity and overweight are global health problems. Aim To evaluate the diagnostic accuracy of liver stiffness measurement (LSM) using acoustic radiation force impulse (ARFI) elastography in overweight and obese patients for staging liver fibrosis. Methods Ninety-seven patients (mean age: 50 years, 50% male) with body mass index (BMI) ≥25 kg/m2 (mean BMI: 31 kg/m2) were prospectively enrolled. All patients underwent ARFI elastography and liver biopsy. In 87/97 patients, transien...
21 CitationsSource
#1Christophe Cassinotto (French Institute of Health and Medical Research)H-Index: 2
#2Jérôme BoursierH-Index: 39
Last. Christophe AubéH-Index: 32
view all 15 authors...
Nonalcoholic fatty liver disease (NAFLD) has become a major public health issue. The goal of this study was to assess the clinical use of liver stiffness measurement (LSM) evaluated by supersonic shear imaging (SSI), FibroScan, and acoustic radiation force impulse (ARFI) in a cohort of NAFLD patients who underwent liver biopsy. A total of 291 NAFLD patients were prospectively enrolled from November 2011 to February 2015 at 2 French university hospitals. LSM was assessed by SSI, FibroScan (M prob...
245 CitationsSource
#1Kento Imajo (YCU: Yokohama City University)H-Index: 25
#2Takaomi Kessoku (YCU: Yokohama City University)H-Index: 19
Last. Atsushi Nakajima (YCU: Yokohama City University)H-Index: 82
view all 18 authors...
Background & Aims Noninvasive methods have been evaluated for the assessment of liver fibrosis and steatosis in patients with nonalcoholic fatty liver disease (NAFLD). We compared the ability of transient elastography (TE) with the M-probe, and magnetic resonance elastography (MRE) to assess liver fibrosis. Findings from magnetic resonance imaging (MRI)−based proton density fat fraction (PDFF) measurements were compared with those from TE-based controlled attenuation parameter (CAP) measurements...
375 CitationsSource
#1Jeffrey CuiH-Index: 8
#2Elhamy Heba (UCSD: University of California, San Diego)H-Index: 13
Last. Rohit LoombaH-Index: 91
view all 10 authors...
Magnetic resonance elastography (MRE), an advanced magnetic resonance–based imaging technique, and acoustic radiation force impulse (ARFI), an ultrasound-based imaging technique, are accurate for diagnosing nonalcoholic fatty liver disease (NAFLD) fibrosis. However, no head-to-head comparisons between MRE and ARFI for diagnosing NAFLD fibrosis have been performed. We compared MRE versus ARFI head-to-head for diagnosing fibrosis in well-characterized patients with biopsy-proven NAFLD. This cross-...
128 CitationsSource
#1Ying Li (PKU: Peking University)H-Index: 62
#1Yongxiang Li (PKU: Peking University)H-Index: 61
Last. Hui Zhuang (PKU: Peking University)H-Index: 42
view all 8 authors...
Summary Background Transient elastography is a non-invasive method for staging liver fibrosis. The meta-analysis using the hierarchical models to evaluate the diagnostic accuracy of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B was rarely reported. Aim A meta-analysis using the hierarchical models was performed to assess transient elastography for diagnosing and stage liver fibrosis in patients with chronic hepatitis B. Methods Electronic databases...
66 CitationsSource
#1Erin K. Spengler (UIHC: University of Iowa Hospitals and Clinics)H-Index: 4
#2Rohit Loomba (UCSD: University of California, San Diego)H-Index: 91
Abstract Nonalcoholic fatty liver disease (NAFLD) is the primary cause of chronic liver disease in the United States, afflicting an estimated 80 to 100 million Americans. Nonalcoholic fatty liver disease is a spectrum of liver diseases composed of nonalcoholic fatty liver and nonalcoholic steatohepatitis (NASH). Although nonalcoholic fatty liver has a negligible risk of progression, patients with NASH often develop cirrhosis or hepatocellular carcinoma. Although liver biopsy is required to diagn...
128 CitationsSource
#1Haixia LiuH-Index: 1
#2Jing FuH-Index: 1
Last. Fang LiH-Index: 1
view all 5 authors...
Background In order to better monitor non-alcoholic fatty liver disease (NAFLD) patients at higher risk for HCC, there is a need for non-invasive diagnostic approaches to screen for the presence of advanced fibrosis in these patients. The aim of this systematic review and meta-analysis will be to evaluate the diagnostic efficacy of ARFI elastography in detecting hepatic fibrosis in NAFLD patients. Methods Relevant studies were identified from systematic searches of several major electronic datab...
75 CitationsSource
#1Mary E. Rinella (NU: Northwestern University)H-Index: 37
#1Mary E. Rinella (NU: Northwestern University)H-Index: 30
Importance Nonalcoholic fatty liver disease and its subtype nonalcoholic steatohepatitis affect approximately 30% and 5%, respectively, of the US population. In patients with nonalcoholic steatohepatitis, half of deaths are due to cardiovascular disease and malignancy, yet awareness of this remains low. Cirrhosis, the third leading cause of death in patients with nonalcoholic fatty liver disease, is predicted to become the most common indication for liver transplantation. Objectives To illustrat...
1,177 CitationsSource
Cited By39
Newest
#1Mohammad Sajad Manuchehri (UT: University of Tehran)H-Index: 1
#2Seyed Kamaledin Setarehdan (UT: University of Tehran)H-Index: 16
Abstract null null Modern medicine cannot ignore the significance of elastography in diagnosis and treatment plans. Despite improvements in accuracy and spatial resolution of elastograms, robustness against noise remains a neglected attribute. A method that can perform in a satisfactory manner under noisy conditions may prove useful for various elastography methods. Here, we propose a method based on eigenvalue decomposition (EVD). In this method, the estimated time delay is defined as the index...
Source
#1Burcu Artunc-Ulkumen (Celal Bayar University)H-Index: 7
#2Kenan Kirteke (Celal Bayar University)
Last. Faik Mumtaz Koyuncu (Celal Bayar University)H-Index: 13
view all 3 authors...
The aim of this study was to investigate the effect of maternal serum Vitamin D levels on the elasticity of placenta. Seventy-four spontaneously conceived singleton pregnancies in their first trime...
Source
Source
#1Adele TaibbiH-Index: 15
#2Salvatore PettaH-Index: 64
view all 9 authors...
PURPOSE This study prospectively assessed the performance of liver stiffness measurements using point shear-wave elastography (p-SWE) in comparison with transient elastography (TE) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD). METHODS Fifty-six consecutive adult patients with a histological diagnosis of NAFLD prospectively underwent TE and p-SWE on the same day. The median of 10 measurements (SWE-10), the first five (SWE-5), and the first three (SWE-3) measurements wer...
1 CitationsSource
#1Annalisa BerzigottiH-Index: 56
Last. Maja ThieleH-Index: 20
view all 8 authors...
Summary null null Non-invasive tests are increasingly being used to improve the diagnosis and prognostication of chronic liver diseases across aetiologies. Herein, we provide the latest update to the EASL Clinical Practice Guidelines on the use of non-invasive tests for the evaluation of liver disease severity and prognosis, focusing on the topics for which relevant evidence has been published in the last 5 years.
3 CitationsSource
BACKGROUND AND AIMS Transient elastography (TE) to estimate liver stiffness has proved to be very useful in the diagnosis of chronic liver disease. Here, we intend to evaluate its use in a large Spanish cohort. METHOD Nested study within the PREVHEP-ETHON (Epidemiological sTudy of Hepatic infectiONs; NCT02749864) population-based, cross-sectional study performed between July 2015 and April 2017. An epidemiological questionnaire, laboratory tests and TE and anthropometric measurements were obtain...
Source
#1Douglas Maya-Miles (University of Seville)H-Index: 2
#2Javier AmpueroH-Index: 20
Last. Manuel Romero-GómezH-Index: 68
view all 5 authors...
The prevalence of non alcoholic fatty liver disease (NAFLD) has increased to 25% in the general population and could double by 2030. Liver fibrosis is the main indicator of morbidity and mortality and recent estimations suggest a substantial number of individuals with undiagnosed advanced liver disease. Strategies to monitor advanced fibrosis are essential for early detection, referral, diagnosis and treatment in primary care and endocrine units, where NAFLD and consequently liver fibrosis are m...
Source
#1A. Liguori (CUA: The Catholic University of America)H-Index: 4
#2Maria Elena Ainora (CUA: The Catholic University of America)H-Index: 11
Last. Luca Miele (CUA: The Catholic University of America)H-Index: 39
view all 10 authors...
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and its prevalence is even higher in patients with risk factors such as type 2 diabetes and obesity. Liver biopsy is the gold standard for diagnosis of non-alcoholic steatohepatitis (NASH), particularly for the assessment of fibrosis stage that is a key prognostic factor. Noninvasive methods for assessment of liver fibrosis are a huge need in contemporary hepatology in order to stratify patient'...
Source
#1Emmanuel Anandraj Selvaraj (University of Oxford)H-Index: 2
#2Ferenc E. Mozes (University of Oxford)H-Index: 5
Last. Lynda C. DowardH-Index: 27
view all 131 authors...
Abstract Background and Aims Vibration-controlled transient elastography (VCTE), point shear wave elastography (pSWE), two-dimensional shear wave elastography (2DSWE), magnetic resonance elastography (MRE), and magnetic resonance imaging (MRI) are proposed as non-invasive tests for patients with non-alcoholic fatty liver disease (NAFLD). This study evaluated their diagnostic accuracy for liver fibrosis and non-alcoholic steatohepatitis (NASH). Methods PubMED/MEDLINE, EMBASE and the Cochrane Libr...
3 CitationsSource
#1Kalliopi ZachouH-Index: 30
#2Vasiliki LygouraH-Index: 4
Last. George N. DalekosH-Index: 31
view all 7 authors...
INTRODUCTION AND OBJECTIVES We assessed FibroMeter virus (FMvirus) and FibroMeter vibration-controlled transient elastography (FMVCTE) in 134 patients with autoimmune liver diseases [ALD, autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC)], in order to assess new potential non-invasive biomarkers of liver fibrosis in patients with ALD, as similar data are missing. PATIENTS AND METHODS The following groups were included: group 1: n = 78 AIH; group 2: n = 56 PBC. FMvirus and FMVCTE w...
1 CitationsSource