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Performance of two-dimensional shear wave elastography for detecting advanced liver fibrosis and cirrhosis in patients with biliary atresia: a systematic review and meta-analysis

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Abstract

Background

Two-dimensional shear wave elastography (2D-SWE) has been proposed for detecting liver fibrosis in biliary atresia.

Objectives

To assess the performance of 2D-SWE for detecting advanced liver fibrosis and cirrhosis in patients with biliary atresia.

Materials and Methods

Five electronic databases were searched to identify studies investigating the performance of 2D-SWE for diagnosing liver fibrosis in biliary atresia in children. We constructed the summary receiver operating characteristic (SROC) curves of 2D-SWE for detecting advanced liver fibrosis and cirrhosis, and then calculated the area under the SROC curves (AUROCs).

Results

Six studies with 470 patients (ages 55 days to 6.6 years) were included. The median correlation coefficient of 2D-SWE with pathological liver fibrosis stages was 0.779 (range: 0.443‒0.813). The summary AUROCs for advanced liver fibrosis and cirrhosis were 0.929 and 0.883, respectively. The summary sensitivity and specificity of 2D-SWE for advanced liver fibrosis were 88% (95% confidence interval [CI]: 80‒94%) and 85% (95% CI: 77‒91%) with I values of 0% and 45.6%, respectively, and for cirrhosis were 80% (95% CI: 72‒87%) and 82% (95% CI: 77‒86%) with I values of 12.9% and 0%, respectively. The diagnostic odds ratio (DOR) of 2D-SWE for advanced liver fibrosis and cirrhosis were 40.3 (95% CI: 18.2‒89.4) and 18.9 (95% CI: 11.2‒31.7), respectively. For preoperative detection of cirrhosis, the pooled AUROC, sensitivity, specificity, and DOR based on the four 2D-SWE studies were 0.877, 79% (95% CI: 71‒86%), 82% (95% CI: 77‒86%), and 17.58 (95% CI: 10.35‒29.85), respectively.

Conclusions

Results show that 2D-SWE has potential as a non-invasive tool for detecting advanced liver fibrosis and cirrhosis in patients with biliary atresia.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, 362000, Fujian, China

    Bingtian Dong, Huaming Wang, Yongjian Chen & Guorong Lyu

  2. Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, China

    Bingtian Dong & Yayang Duan

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  1. Bingtian Dong
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  2. Yayang Duan
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  3. Huaming Wang
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  4. Yongjian Chen
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  5. Guorong Lyu
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Contributions

G.R.L. is the guarantor of the article: B.T.D., H.M.W., and G.R.L. conceptualized the study. All authors contributed to the study design. B.T.D., Y.Y.D., and H.M.W. performed the literature search, analyzed the data, and performed the statistical analysis. B.T.D. and Y.J.C. drafted the initial manuscript. All authors reviewed and approved the final manuscript.

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Correspondence to Guorong Lyu.

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Dong, B., Duan, Y., Wang, H. et al. Performance of two-dimensional shear wave elastography for detecting advanced liver fibrosis and cirrhosis in patients with biliary atresia: a systematic review and meta-analysis. Pediatr Radiol 53, 2642–2650 (2023). https://doi.org/10.1007/s00247-023-05796-2

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  • DOI: https://doi.org/10.1007/s00247-023-05796-2

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