Accuracy of real-time shear wave elastography in staging hepatic fibrosis: a meta-analysis

Abstract

Background: Chronic liver disease (CLD) is an important cause of morbidity and mortality and can lead to hepatic fibrosis. This study was conducted to evaluate the diagnostic value of real-time shear wave elastography (SWE) in the assessment of hepatic fibrosis.

Methods: A systematic search of databases was performed for publications on SWE during the period between 2010 and 2017. The identified studies were analyzed using Meta-disc 1.4 software to integrate and analyze the data.

Results: Eleven studies comprising 1560 patients were included for analysis. The pooled sensitivity, specificity and diagnostic odds ratio were 0.85 (95% CI: 0.82-0.87), 0.79 (95% CI: 0.76-0.82) and 30.81 (95% CI: 16.55-57.34), respectively for patients with a Metavir-score of ≥ F2; 0.87 (95% CI: 0.84-0.91), 0.84 (95% CI: 0.82-0.87), 41.45 (95% CI:18.25-94.45), respectively for patients with ≥ F3; 0.88(95% CI: 0.83-0.91), 0.91 (95% CI: 0.89-0.92), 67.18 (95% CI:30.02-150.31), respectively for patients with ≥ F4. The areas under the receiver operating characteristic curve of the three groups were 0.9147, 0.9223 and 0.9520, respectively.

Conclusions: Our work demonstrates that SWE is highly accurate for detecting and staging hepatic fibrosis.

Keywords: Cirrhosis; Elastography; Hepatic fibrosis; Meta-analysis.

Fig. 1

Flow diagram of studies included according to the inclusion and exclusion criteria

Fig. 2

Forest plots of diagnostic odds ratios (DOR) from 11 test accuracy studies showing the results from 11 studies in detecting and staging hapetic fibrosis. a ≥ F2, b ≥ F3, and c ≥ F4

Fig. 3

Summary receiver operating characteristic (SROC) curves with 95% confidenceintervals (shown as upper and lower curves) for estimating the diagnosis accuracy of SWE a ≥ F2, b ≥ F3, and c ≥ F4. Dots represent the sensitivity and specificity of each included study