Diagnostic Accuracy of 2D-Shear Wave Elastography for Liver Fibrosis Severity: A Meta-Analysis

PLoS One. 2016 Jun 14;11(6):e0157219. doi: 10.1371/journal.pone.0157219. eCollection 2016.

Abstract

Purpose: To evaluate the accuracy of shear wave elastography (SWE) in the quantitative diagnosis of liver fibrosis severity.

Methods: The published literatures were systematically retrieved from PubMed, Embase, Web of science and Scopus up to May 13th, 2016. Included studies reported the pooled sensitivity, specificity, positive and negative predictive values, as well as the diagnostic odds ratio of SWE in populations with liver fibrosis. A bivariate mixed-effects regression model was used, which was estimated by the I2 statistics. The quality of articles was evaluated by quality assessment of diagnostic accuracy studies (QUADAS).

Results: Thirteen articles including 2303 patients were qualified for the study. The pooled sensitivity and specificity of SWE for the diagnosis of liver fibrosis are as follows: ≥F1 0.76 (p<0.001, 95% CI, 0.71-0.81, I2 = 75.33%), 0.92 (p<0.001, 95% CI, 0.80-0.97, I2 = 79.36%); ≥F2 0.84 (p = 0.35, 95% CI, 0.81-0.86, I2 = 9.55%), 0.83 (p<0.001, 95% CI, 0.77-0.88, I2 = 86.56%); ≥F3 0.89 (p = 0.56, 95% CI, 0.86-0.92, I2 = 0%), 0.86 (p<0.001, 95% CI, 0.82-0.90, I2 = 75.73%); F4 0.89 (p = 0.24, 95% CI, 0.84-0.92, I2 = 20.56%), 0.88 (p<0.001, 95% CI, 0.84-0.92, I2 = 82.75%), respectively. Sensitivity analysis showed no significant changes if any one of the studies was excluded. Publication bias was not detected in this meta-analysis.

Conclusions: Our study suggests that SWE is a helpful method to appraise liver fibrosis severity. Future studies that validate these findings would be appropriate.

Publication types

  • Meta-Analysis

MeSH terms

  • Area Under Curve
  • Elasticity Imaging Techniques / methods*
  • Humans
  • Liver / diagnostic imaging*
  • Liver Cirrhosis / diagnostic imaging*
  • ROC Curve
  • Sensitivity and Specificity

Grants and funding

This study was supported by the opening foundation of the State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Medical College, Zhejiang University, grant NO. 2015KF06. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.