Magnetic resonance elastography and acoustic radiation force impulse for staging hepatic fibrosis: a meta-analysis
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- Guo, Y., Parthasarathy, S., Goyal, P. et al. Abdom Imaging (2015) 40: 818. doi:10.1007/s00261-014-0137-6
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).
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.
MRE is more accurate than ARFI with a higher combination of sensitivity, specificity, LR, and AUROC particularly in diagnosing early stages of hepatic fibrosis.
KeywordsHepatic fibrosisMagnetic resonance imagingMR elastographyAcoustic radiation force impulseMeta-analysis
Aspartate aminotransferase-to-platelet ratio index
Acoustic radiation force impulse
Area under the receiver operating characteristic curve
Alcoholic liver disease
Body mass index
Chronic liver disease
Chronic hepatitis C
Chronic hepatitis B
Diagnostic odds ratio
Human immunodeficiency virus
Hepatitis C virus
Positive likelihood ratio
Negative likelihood ratio
Magnetic resonance elastography
Negative predictive value
Non-alcoholic fatty liver disease
Positive predictive value
Primary biliary cirrhosis
Primary sclerosing cholangitis
Receiver operating characteristics