Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis - PubMed (original) (raw)

. 2016 May;26(5):1431-40.

doi: 10.1007/s00330-015-3949-z. Epub 2015 Aug 28.

Sudhakar K Venkatesh 2, Rohit Loomba 3, Zhen Wang 4, Claude Sirlin 5, Jun Chen 6, Meng Yin 6, Frank H Miller 7, Russell N Low 8, Tarek Hassanein 9, Edmund M Godfrey 10, Patrick Asbach 11, Mohammad Hassan Murad 4, David J Lomas 10, Jayant A Talwalkar 1, Richard L Ehman 6

Affiliations

Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis

Siddharth Singh et al. Eur Radiol. 2016 May.

Abstract

Objectives: 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).

Methods: 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).

Results: 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.

Conclusions: MRE has high diagnostic accuracy for detection of fibrosis in NAFLD, independent of BMI and degree of inflammation.

Key points: • 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.

Keywords: Biomarker; Cirrhosis; Diagnostic performance; Elastography; Fibrosis.

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Conflict of interest statement

This research has been reviewed by the Mayo Clinic Conflict of Interest Review Board and is being conducted in compliance with Mayo Clinic Conflict of Interest policies. None of the other authors have any disclosures.

Figures

Figure 1

Figure 1

Flow sheet summarizing study identification and selection.

Figure 2

Figure 2

Composite box-plot graph showing magnetic resonance elastography (MRE), stiffness values for various stages of fibrosis. Horizontal line through each box represents a median value and each box top and bottom represent data from the 25th to 75th percentile (middle 50% of observations). Whiskers represent data from minimum to maximum excluding outliers which are represented as separate dots.

References

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