Format

Send to

Choose Destination
Clin Gastroenterol Hepatol. 2015 Mar;13(3):440-451.e6. doi: 10.1016/j.cgh.2014.09.046. Epub 2014 Nov 20.

Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data.

Author information

1
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
2
Department of Radiology, Mayo Clinic, Rochester, Minnesota. Electronic address: venkatesh.sudhakar@mayo.edu.
3
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
4
Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
5
Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi, Japan.
6
Sharp and Children's Magnetic Resonance Imaging Center, San Diego, California.
7
Liver Centers of Southern California, Coronado, California.
8
Department of Radiology, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany.
9
Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom.
10
Department of Radiology, Mayo Clinic, Rochester, Minnesota.
11
Department of Transplant, Mayo Clinic, Jacksonville, Florida.
12
Department of Radiology, Department of Medicine, Mayo Clinic, Jacksonville, Florida.
13
Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.

Abstract

BACKGROUND & AIMS:

Magnetic resonance elastography (MRE) is a noninvasive tool for staging liver fibrosis. We conducted a meta-analysis of individual participant data collected from published studies to assess the diagnostic accuracy of MRE for staging liver fibrosis in patients with chronic liver diseases (CLD).

METHODS:

Through a systematic literature search of multiple databases (2003-2013), we identified studies on diagnostic performance of MRE for staging liver fibrosis in patients with CLD with native anatomy, using liver biopsy as the standard. We contacted study authors to collect data on each participant's age, sex, body mass index (BMI), liver stiffness (measured by MRE), fibrosis stage, staging system used, degree of inflammation, etiology of CLD, and interval between MRE and biopsy. Through a pooled analysis, we calculated cluster-adjusted area under the receiver-operating curve, sensitivity, and specificity of MRE for any fibrosis (≥stage 1), significant fibrosis (≥stage 2), advanced fibrosis (≥stage 3), and cirrhosis (stage 4).

RESULTS:

We analyzed data from 12 retrospective studies, comprising 697 patients (mean age, 55 ± 13 y; 59.4% male; mean BMI, 26.9 ± 6.7 kg/m(2); 92.1% with <1 year interval between MRE and biopsy; and 47.1% with hepatitis C). Overall, 19.5%, 19.4%, 15.5%, 15.9%, and 29.7% patients had stage 0, 1, 2, 3, and 4 fibrosis, respectively. The mean area under the receiver-operating curve values (and 95% confidence intervals) for the diagnosis of any (≥stage 1), significant (≥stage 2), advanced fibrosis (≥stage 3), and cirrhosis, were as follows: 0.84 (0.76-0.92), 0.88 (0.84-0.91), 0.93 (0.90-0.95), and 0.92 (0.90-0.94), respectively. A similar diagnostic performance was observed in stratified analysis based on sex, obesity, and etiology of CLD. The overall rate of failure of MRE was 4.3%.

CONCLUSIONS:

Based on a pooled analysis of data from individual participants, MRE has a high accuracy for the diagnosis of significant or advanced fibrosis and cirrhosis, independent of BMI and etiology of CLD. Prospective studies are warranted to better understand the diagnostic performance of MRE.

KEYWORDS:

Diagnostic Performance; Elastography; IPD; Noninvasive; Pooled Analysis

PMID:
25305349
PMCID:
PMC4333001
DOI:
10.1016/j.cgh.2014.09.046
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center