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Meta-Analysis
. 2021 Aug;46(8):3889-3907.
doi: 10.1007/s00261-021-03055-2. Epub 2021 Mar 26.

Comparison of diffusion-weighted imaging and MR elastography in staging liver fibrosis: a meta-analysis

Weon Jang  1   2   3 , Seongil Jo  4 , Ji Soo Song  5   6   7 , Hong Pil Hwang  8 , Seong-Hun Kim  9
Affiliations
Meta-Analysis

Comparison of diffusion-weighted imaging and MR elastography in staging liver fibrosis: a meta-analysis

Weon Jang et al. Abdom Radiol (NY). 2021 Aug.

Erratum in

Abstract

Purpose: To compare the diagnostic performance of diffusion-weighted imaging (DWI), gradient-recalled echo-based magnetic resonance elastography (GRE-MRE), and spin-echo echo-planar imaging-based MRE (SE-EPI-MRE) in liver fibrosis staging.

Methods: A systematic literature search was done to collect studies on the performance of DWI, GRE-MRE, and SE-EPI-MRE for diagnosing liver fibrosis. Pooled sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratio, and a summary receiver operating characteristic (ROC) curve were estimated with a bivariate random effects model. Subgroup analyses on various study characteristics were performed.

Results: Sixty studies with a total of 6620 patients were included in the meta-analysis. Pooled sensitivity and specificity of GRE-MRE and SE-EPI-MRE showed high diagnostic accuracy and did not differ significantly. The area under the summary ROC curve for all stages of fibrosis differed significantly between DWI (0.83-0.88) and either GRE-MRE (0.95-0.97) or SE-EPI-MRE (0.95-0.99). Substantial heterogeneity was detected for all three imaging methods.

Conclusions: Both GRE-MRE and SE-EPI-MRE are highly accurate for detection of each liver fibrosis stage, with high potential to replace liver biopsy. Although DWI had a moderate accuracy in distinguishing liver fibrosis, it could be regarded as an alternative to MRE, since it is widely available and easily implemented in routine liver MRI.

Keywords: Diffusion-weighted image; Liver fibrosis; Magnetic resonance elastography; Meta-analysis.

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