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Hepatology. 2018 Jan;67(1):260-272. doi: 10.1002/hep.29179. Epub 2017 Nov 15.

Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis.

Author information

1
Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany.
2
Hepatology Unit, Centre Hospitalier Universitaire, Bordeaux, France.
3
INSERM U1053, Bordeaux University, Bordeaux, France.
4
Department of Diagnostic and Interventional Imaging, Centre Hospitalier Universitaire du Haut-Lévèque, Bordeaux, France.
5
Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
6
Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
7
Infectious Diseases Department, Ultrasound Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
8
Department of Hepatology, Assistance Publique de Hôpitaux de ParisHôpital Universitaire Beaujon, Clichy, France.
9
Department of Radiology, Assistance Publique de Hôpitaux de Paris, Hôpital Universitaire Beaujon, Clichy, France.
10
Department of Hepatology, Hospices Civils de Lyon, Hôpital Universitaire Edouard Herriot, Lyon, France.
11
Department of Radiology, Centre Hospitalier Général de Perpignan, Perpignan, France.
12
Department of Hepatology, Assistance Publique de Hôpitaux de Paris, Hôpital Cochin, and Université Paris Descartes and INSERM UMS20, Institut Pasteur, Paris, France.
13
Department of Internal Medicine I, Universitätsklinikum Bonn, Bonn, Germany.
14
Research Unit for Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.
15
European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain.
16
Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
17
Division of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.
18
Department of Internal Medicine, Athens University School of Medicine, Athens, Greece.
19
Department of Radiology, Athens University School of Medicine, Athens, Greece.
20
Department of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
21
SuperSonic Imagine, Aix-en-Provence, France.
22
INSERM U979-Institut Langevin-ESPCI ParisTec, Paris, France.
23
Department of Internal Medicine, Goethe University Hospital Frankfurt, Frankfurt, Germany.

Abstract

Two-dimensional shear wave elastography (2D-SWE) has proven to be efficient for the evaluation of liver fibrosis in small to moderate-sized clinical trials. We aimed at running a larger-scale meta-analysis of individual data. Centers which have worked with Aixplorer ultrasound equipment were contacted to share their data. Retrospective statistical analysis used direct and paired receiver operating characteristic and area under the receiver operating characteristic curve (AUROC) analyses, accounting for random effects. Data on both 2D-SWE and liver biopsy were available for 1,134 patients from 13 sites, as well as on successful transient elastography in 665 patients. Most patients had chronic hepatitis C (n = 379), hepatitis B (n = 400), or nonalcoholic fatty liver disease (n = 156). AUROCs of 2D-SWE in patients with hepatitis C, hepatitis B, and nonalcoholic fatty liver disease were 86.3%, 90.6%, and 85.5% for diagnosing significant fibrosis and 92.9%, 95.5%, and 91.7% for diagnosing cirrhosis, respectively. The AUROC of 2D-SWE was 0.022-0.084 (95% confidence interval) larger than the AUROC of transient elastography for diagnosing significant fibrosis (P = 0.001) and 0.003-0.034 for diagnosing cirrhosis (P = 0.022) in all patients. This difference was strongest in hepatitis B patients.

CONCLUSION:

2D-SWE has good to excellent performance for the noninvasive staging of liver fibrosis in patients with hepatitis B; further prospective studies are needed for head-to-head comparison between 2D-SWE and other imaging modalities to establish disease-specific appropriate cutoff points for assessment of fibrosis stage. (Hepatology 2018;67:260-272).

PMID:
28370257
PMCID:
PMC5765493
DOI:
10.1002/hep.29179
[Indexed for MEDLINE]
Free PMC Article

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