Abdominal Imaging

, Volume 40, Issue 4, pp 818–834

Magnetic resonance elastography and acoustic radiation force impulse for staging hepatic fibrosis: a meta-analysis

  • Yang Guo
  • Sudharshan Parthasarathy
  • Preeya Goyal
  • Robert J. McCarthy
  • Andrew C. Larson
  • Frank H. Miller
Article

DOI: 10.1007/s00261-014-0137-6

Cite this article as:
Guo, Y., Parthasarathy, S., Goyal, P. et al. Abdom Imaging (2015) 40: 818. doi:10.1007/s00261-014-0137-6
Part of the following topical collections:
  1. Special Focus Section: Elastography

Abstract

Purpose

Elastography is a non-invasive method to quantify fibrosis based on tissue mechanical properties. We performed a meta-analysis to assess the diagnostic accuracy of two such techniques: Acoustic Radiation Force Impulse Imaging (ARFI) or Magnetic Resonance Elastography (MRE) for staging hepatic fibrosis.

Materials and Methods

Literature databases were searched until June 2013. Inclusion criteria were evaluation of MRE or ARFI, liver biopsy, and reported sensitivity and specificity. A random effects model was used to combine sensitivity and specificity, from which positive (LR+) and negative (LR−) likelihood ratios, diagnostic odds ratios, and area under receiver operating characteristics curve (AUROC) were derived. Differences between MRE and ARFI were compared with t tests (P < 0.05 considered significant).

Results

Eleven MRE studies including 982 patients and fifteen ARFI studies including 2,128 patients were selected. AUROC for MRE staging fibrosis were 0.94, 0.97, 0.96, and 0.97 for F1–F4, respectively, whereas AUROC for ARFI staging were 0.82, 0.85, 0.94, and 0.94 for F1–F4, respectively. Significance was found in AUROC between MRE and ARFI for the diagnosis of stage 1 and 2 fibrosis.

Conclusion

MRE is more accurate than ARFI with a higher combination of sensitivity, specificity, LR, and AUROC particularly in diagnosing early stages of hepatic fibrosis.

Keywords

Hepatic fibrosisMagnetic resonance imagingMR elastographyAcoustic radiation force impulseMeta-analysis

Abbreviations

APRI

Aspartate aminotransferase-to-platelet ratio index

ARFI

Acoustic radiation force impulse

AUROC

Area under the receiver operating characteristic curve

ALD

Alcoholic liver disease

AIH

Autoimmune hepatitis

BMI

Body mass index

CLD

Chronic liver disease

CHC

Chronic hepatitis C

CHB

Chronic hepatitis B

CI

Confidence interval

CT

Computed tomography

DOR

Diagnostic odds ratio

ECM

Extracellular matrix

FP

False positive

FN

False negative

HIV

Human immunodeficiency virus

HCV

Hepatitis C virus

kPa

kilopascal

LR+

Positive likelihood ratio

LR−

Negative likelihood ratio

MRE

Magnetic resonance elastography

NPV

Negative predictive value

NAFLD

Non-alcoholic fatty liver disease

NASH

Non-alcoholic steatohepatitis

PPV

Positive predictive value

PBC

Primary biliary cirrhosis

PSC

Primary sclerosing cholangitis

ROC

Receiver operating characteristics

Se

Sensitivity

Sp

Specificity

TE

Transient elastography

TP

True positive

TN

True negative

US

Ultrasound

Supplementary material

261_2014_137_MOESM1_ESM.doc (160 kb)
Supplementary material 1 (DOC 160 kb)
261_2014_137_MOESM2_ESM.doc (544 kb)
Supplementary material 2 (DOC 544 kb)

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Yang Guo
    • 1
  • Sudharshan Parthasarathy
    • 2
  • Preeya Goyal
    • 1
  • Robert J. McCarthy
    • 3
  • Andrew C. Larson
    • 1
    • 4
  • Frank H. Miller
    • 1
  1. 1.Department of RadiologyNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Chicago Medical SchoolRosalind Franklin University of MedicineChicagoUSA
  3. 3.Department of AnesthesiologyNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Department of Biomedical EngineeringNorthwestern UniversityEvanstonUSA