مورد إلكتروني
Diagnostic accuracy of elastography and magnetic resonance imaging in patients with NAFLD: A systematic review and meta-analysis
| العنوان: | Diagnostic accuracy of elastography and magnetic resonance imaging in patients with NAFLD: A systematic review and meta-analysis |
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| بيانات النشر: | Elsevier 2021-10 |
| تفاصيل مُضافة: | Innovative Medicines Initiative European Commission European Federation of Pharmaceutical Industries and Associations Selvaraj, Emmanuel Anandraj Mózes, Ferenc Emil Jayaswal, Arjun Narayan Ajmer Zafarmand, Mohammad Hadi Vali, Yasaman Lee, Jenny A. Levick, Christina Kim Young, Liam Arnold Joseph Palaniyappan, Naaventhan Liu, Chang-Hai Aithal, Guruprasad P. Romero-Gómez, Manuel Brosnan, M. Julia Tuthill, Theresa A. Anstee, Quentin M. Neubauer, Stefan Harrison, Stephen A. Bossuyt, Patrick M. Pavlides, Michael |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | [Background and Aims] Vibration-controlled transient elastography (VCTE), point shear wave elastography (pSWE), 2-dimensional shear wave elastography (2DSWE), magnetic resonance elastography (MRE), and magnetic resonance imaging (MRI) have been proposed as non-invasive tests for patients with non-alcoholic fatty liver disease (NAFLD). This study evaluated their diagnostic accuracy for liver fibrosis and non-alcoholic steatohepatitis (NASH). [Methods] PubMED/MEDLINE, EMBASE and the Cochrane Library were searched for studies examining the diagnostic accuracy of these index tests, against histology as the reference standard, in adult patients with NAFLD. Two authors independently screened and assessed methodological quality of studies and extracted data. Summary estimates of sensitivity, specificity and area under the curve (sAUC) were calculated for fibrosis stages and NASH, using a random effects bivariate logit-normal model. [Results] We included 82 studies (14,609 patients). Meta-analysis for diagnosing fibrosis stages was possible in 53 VCTE, 11 MRE, 12 pSWE and 4 2DSWE studies, and for diagnosing NASH in 4 MRE studies. sAUC for diagnosis of significant fibrosis were: 0.83 for VCTE, 0.91 for MRE, 0.86 for pSWE and 0.75 for 2DSWE. sAUC for diagnosis of advanced fibrosis were: 0.85 for VCTE, 0.92 for MRE, 0.89 for pSWE and 0.72 for 2DSWE. sAUC for diagnosis of cirrhosis were: 0.89 for VCTE, 0.90 for MRE, 0.90 for pSWE and 0.88 for 2DSWE. MRE had sAUC of 0.83 for diagnosis of NASH. Three (4%) studies reported intention-to-diagnose analyses and 15 (18%) studies reported diagnostic accuracy against pre-specified cut-offs. [Conclusions] When elastography index tests are acquired successfully, they have acceptable diagnostic accuracy for advanced fibrosis and cirrhosis. The potential clinical impact of these index tests cannot be assessed fully as intention-to-diagnose analyses and validation of pre-specified thresholds are lacking. [Lay summary] Non-invasive tests that measure liver stiffness or use magnetic resonance imaging (MRI) have been suggested as alternatives to liver biopsy for assessing the severity of liver scarring (fibrosis) and fatty inflammation (steatohepatitis) in patients with non-alcoholic fatty liver disease (NAFLD). In this study, we summarise the results of previously published studies on how accurately these non-invasive tests can diagnose liver fibrosis and inflammation, using liver biopsy as the reference. We found that some techniques that measure liver stiffness had a good performance for the diagnosis of severe liver scarring. |
| مصطلحات الفهرس: | Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis, Biomarkers, Liver fibrosis, Transient elastography, Shear wave elastography, Magnetic resonance elastography, Iron-corrected T1, Diffusion-weighted imaging, deMILI, fibro-MRI, NASH-MRI, artículo |
| URL: | Publisher's version Sí info:eu-repo/grantAgreement/EC/H2020/777377 |
| الإتاحة: | Open access content. Open access content https://creativecommons.org/licenses/by-nc-nd/4.0 openAccess |
| ملاحظة: | English |
| أرقام أخرى: | CTK oai:digital.csic.es:10261/262952 Journal of Hepatology 75(4): 770-785 (2021) 0168-8278 10.1016/j.jhep.2021.04.044 1306018646 |
| المصدر المساهم: | CSIC From OAIster®, provided by the OCLC Cooperative. |
| رقم الأكسشن: | edsoai.on1306018646 |
| قاعدة البيانات: | OAIster |
| الوصف غير متاح. |