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- Title
Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis.
- Authors
Singh, Siddharth; Venkatesh, Sudhakar; Loomba, Rohit; Wang, Zhen; Sirlin, Claude; Chen, Jun; Yin, Meng; Miller, Frank; Low, Russell; Hassanein, Tarek; Godfrey, Edmund; Asbach, Patrick; Murad, Mohammad; Lomas, David; Talwalkar, Jayant; Ehman, Richard; Venkatesh, Sudhakar K; Miller, Frank H; Low, Russell N; Godfrey, Edmund M
- Abstract
<bold>Objectives: </bold>We conducted an individual participant data (IPD) pooled analysis on diagnostic accuracy of MRE to detect fibrosis stage in patients with non-alcoholic fatty liver disease (NAFLD).<bold>Methods: </bold>Through a systematic literature search, we identified studies of MRE (at 60-62.5 Hz) for staging fibrosis in patients with NAFLD, using liver biopsy as gold standard, and contacted study authors for IPD. Through pooled analysis, we calculated the cluster-adjusted AUROC, sensitivity and specificity of MRE for any (≥stage 1), significant (≥stage 2) and advanced (≥stage 3) fibrosis and cirrhosis (stage 4).<bold>Results: </bold>We included nine studies with 232 patients with NAFLD (mean age, 51 ± 13 years; 37.5% males; mean BMI, 33.5 ± 6.7 kg/m(2); interval between MRE and biopsy <1 year, 98.3%). Fibrosis stage distribution (stage 0/1/2/3/4) was 33.6, 32.3, 10.8, 12.9 and 10.4%, respectively. Mean AUROC (and 95% CIs) for diagnosis of any, significant or advanced fibrosis and cirrhosis was 0.86 (0.82-0.90), 0.87 (0.82-0.93), 0.90 (0.84-0.94) and 0.91 (0.76-0.95), respectively. Similar diagnostic performance was observed in stratified analysis based on sex, obesity and degree of inflammation.<bold>Conclusions: </bold>MRE has high diagnostic accuracy for detection of fibrosis in NAFLD, independent of BMI and degree of inflammation.<bold>Key Points: </bold>• MRE has high diagnostic accuracy for detection of fibrosis in NAFLD. • BMI does not significantly affect accuracy of MRE in NAFLD. • Inflammation had no significant influence on MRE performance in NAFLD for fibrosis.
- Subjects
ELASTOGRAPHY; FIBROSIS; FATTY liver; CIRRHOSIS of the liver; LIVER biopsy; BIOPSY; COMPARATIVE studies; HEPATITIS; LIVER; RESEARCH methodology; MEDICAL cooperation; OBESITY; RESEARCH; RESEARCH funding; ULTRASONIC imaging; EVALUATION research
- Publication
European Radiology, 2016, Vol 26, Issue 5, p1431
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-015-3949-z