RT Journal Article
T1 Diagnostic accuracy of elastography and magnetic resonance imaging in patients with NAFLD: A systematic review and meta-analysis.
A1 Selvaraj, Emmanuel Anandraj
A1 Mózes, Ferenc Emil
A1 Jayaswal, Arjun Narayan Ajmer
A1 Zafarmand, Mohammad Hadi
A1 Vali, Yasaman
A1 Lee, Jenny A
A1 Levick, Christina Kim
A1 Young, Liam Arnold Joseph
A1 Palaniyappan, Naaventhan
A1 Liu, Chang-Hai
A1 Aithal, Guruprasad Padur
A1 Romero-Gómez, Manuel
A1 Brosnan, M Julia
A1 Tuthill, Theresa A
A1 Anstee, Quentin M
A1 Neubauer, Stefan
A1 Harrison, Stephen A
A1 Bossuyt, Patrick M
A1 Pavlides, Michael
A1 LITMUS Investigators, 
K1 Biomarkers
K1 Diffusion-weighted imaging
K1 Iron-corrected T1
K1 Liver fibrosis
K1 Magnetic resonance elastography
K1 NASH-MRI
K1 Non-alcoholic fatty liver disease
K1 Non-alcoholic steatohepatitis
K1 Shear wave elastography
K1 Transient elastography
K1 deMILI
K1 fibro-MRI
AB Vibration-controlled transient elastography (VCTE), point shear wave elastography (pSWE), 2-dimensional shear wave elastography (2DSWE), magnetic resonance elastography (MRE), and magnetic resonance imaging (MRI) have been 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). PubMED/MEDLINE, EMBASE and the Cochrane Library were searched for studies examining the diagnostic accuracy of these index tests, against histology as the reference standard, in adult patients with NAFLD. Two authors independently screened and assessed methodological quality of studies and extracted data. Summary estimates of sensitivity, specificity and area under the curve (sAUC) were calculated for fibrosis stages and NASH, using a random effects bivariate logit-normal model. We included 82 studies (14,609 patients). Meta-analysis for diagnosing fibrosis stages was possible in 53 VCTE, 11 MRE, 12 pSWE and 4 2DSWE studies, and for diagnosing NASH in 4 MRE studies. sAUC for diagnosis of significant fibrosis were: 0.83 for VCTE, 0.91 for MRE, 0.86 for pSWE and 0.75 for 2DSWE. sAUC for diagnosis of advanced fibrosis were: 0.85 for VCTE, 0.92 for MRE, 0.89 for pSWE and 0.72 for 2DSWE. sAUC for diagnosis of cirrhosis were: 0.89 for VCTE, 0.90 for MRE, 0.90 for pSWE and 0.88 for 2DSWE. MRE had sAUC of 0.83 for diagnosis of NASH. Three (4%) studies reported intention-to-diagnose analyses and 15 (18%) studies reported diagnostic accuracy against pre-specified cut-offs. When elastography index tests are acquired successfully, they have acceptable diagnostic accuracy for advanced fibrosis and cirrhosis. The potential clinical impact of these index tests cannot be assessed fully as intention-to-diagnose analyses and validation of pre-specified thresholds are lacking. Non-invasive tests that measure liver stiffness or use magnetic resonance imaging (MRI) have been suggested as alternatives to liver biopsy for assessing the severity of liver scarring (fibrosis) and fatty inflammation (steatohepatitis) in patients with non-alcoholic fatty liver disease (NAFLD). In this study, we summarise the results of previously published studies on how accurately these non-invasive tests can diagnose liver fibrosis and inflammation, using liver biopsy as the reference. We found that some techniques that measure liver stiffness had a good performance for the diagnosis of severe liver scarring.
YR 2021
FD 2021-05-13
LK https://hdl.handle.net/10668/27521
UL https://hdl.handle.net/10668/27521
LA en
DS RISalud
RD Apr 17, 2025