Meta‐analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis
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Open Access
- 12 June 2013
- journal article
- research article
- Published by Wiley in Liver International
- Vol. 33 (8), 1138-1147
- https://doi.org/10.1111/liv.12240
Abstract
Aims This meta‐analysis aims to compare the diagnostic performance of acoustic radiation force impulse (ARFI) elastography and transient elastography (TE) in the assessment of liver fibrosis using liver biopsy (LB) as ‘gold‐standard’. Methods PubMed, Medline, Lilacs, Scopus, Ovid, EMBASE, Cochrane and Medscape databases were searched for all studies published until 31 May 2012 that evaluated the liver stiffness by means of ARFI, TE and LB. Information abstracted from each study according to a fixed protocol included study design and methodological characteristics, patient characteristics, interventions, outcomes and missing outcome data. Results Thirteen studies (11 full‐length articles and 2 abstracts) including 1163 patients with chronic hepatopathies were included in the analysis. Inability to obtain reliable measurements was more than thrice as high for TE as that of ARFI (6.6% vs. 2.1%, P < 0.001). For detection of significant fibrosis, (F ≥ 2) the summary sensitivity (Se) was 0.74 (95% CI: 0.66–0.80) and specificity (Sp) was 0.83 (95% CI: 0.75–0.89) for ARFI, while for TE the Se was 0.78 (95% CI: 0.72–0.83) and Sp was 0.84 (95% CI: 0.75–0.90). For the diagnosis of cirrhosis, the summary Se was 0.87 (95% CI: 0.79–0.92) and Sp was 0.87 (95% CI: 0.81–0.91) for ARFI elastography, and, respectively, 0.89 (95% CI: 0.80–0.94) and 0.87 (95% CI: 0.82–0.91) for TE. The diagnostic odds ratio of ARFI and TE did not differ significantly in the detection of significant fibrosis [mean difference in rDOR = 0.27 (95% CI: 0.69–0.14)] and cirrhosis [mean difference in rDOR = 0.12 (95% CI: 0.29–0.52)]. Conclusion Acoustic radiation force impulse elastography seems to be a good method for assessing liver fibrosis, and shows higher rate of reliable measurements and similar predictive value to TE for significant fibrosis and cirrhosis.Keywords
This publication has 54 references indexed in Scilit:
- Evaluation of acoustic radiation force impulse imaging for determination of liver stiffness using transient elastography as a referenceWorld Journal of Gastroenterology, 2012
- Noninvasive evaluation of hepatic fibrosis using acoustic radiation force-based shear stiffness in patients with nonalcoholic fatty liver diseaseJournal of Hepatology, 2011
- Is it better to use two elastographic methods for liver fibrosis assessment?World Journal of Gastroenterology, 2011
- Nonalcoholic Fatty Liver Disease: US-based Acoustic Radiation Force Impulse ElastographyRadiology, 2010
- Noninvasive Evaluation of Hepatic Fibrosis Using Serum Fibrotic Markers, Transient Elastography (FibroScan) and Real-Time Tissue ElastographyIntervirology, 2008
- Performance of Transient Elastography for the Staging of Liver Fibrosis: A Meta-AnalysisGastroenterology, 2008
- Robust Principal Component Analysis and Clustering Methods for Automated Classification of Tissue Response to ARFI ExcitationJapanese Journal of Clinical Oncology, 2008
- Noninvasive markers of fibrosis in nonalcoholic fatty liver disease: Validating the European Liver Fibrosis Panel and exploring simple markersHepatology, 2007
- Assessment of Hepatic Fibrosis With Magnetic Resonance ElastographyClinical Gastroenterology and Hepatology, 2007
- Sampling variability of liver fibrosis in chronic hepatitis CHepatology, 2003