Abstract
BackgroundShear wave elastography (SWE) imaging have been proposed for characterization of focal liver lesions. We conducted a meta-analysis to evaluate the accuracy and clinical utility of SWE imaging for differentiation of malignant and benign hepatic lesions.MethodsPubMed, Embase, Web of Science, and the Cochrane Library were systematically reviewed to search for studies published between January 1, 1990, and November 30, 2018. The studies published in English relating to the evaluation the diagnostic accuracy of SWE imaging for distinguishing malignant and benign liver lesions were retrieved and examined for pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios, using bivariate random-effects models. The hierarchical summary receiver operating characteristic (HSROC) curve was estimated to assess the SWE imaging accuracy. The clinical utility of SWE imaging for differentiation of malignant liver lesions was evaluated by Fagan plot.ResultsA total of 15 studies, involving 1894 liver lesions in 1728 patients, were eligible for the meta-analysis. The pooled sensitivity and specificity for identification of malignant liver lesions were 0.82 (95% CI: 0.77–0.86) and 0.82 (95% CI: 0.76–0.87), respectively. The AUC was 0.89 (95% CI: 0.86–0.91). When the pre-test probability was 50%, after SWE imaging measurement over the cut-off value (positive result), the corresponding post-test probability for the presence of malignant liver lesions was 82%; the post-test probability was 18% after negative measurement.ConclusionsSWE imaging showed high sensitivity and specificity in differentiating malignant and benign liver lesions and may be promising for noninvasive evaluation of liver lesions.Trial registrationThe review was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42018104510.
Highlights
Shear wave elastography (SWE) imaging have been proposed for characterization of focal liver lesions
The cut-off value of shear wave speed in point shear-wave elastography (pSWE) ranged from 1.82 m/s to 2.5 m/s, the cut-off value of Young modulus in two-dimensional shear wave elastography (2D-SWE) ranged from 20.7 Kpa to 24.43 Kpa, and the cut-off value of shear wave velocity (SWV)/elasticity ration (FLL to surrounding liver parenchyma) ranged from 1.3 to 1.67
The results showed that elastography modality, study location, gold standard, blinded interpretation of SWE, and attrition rate were significantly associated with the heterogeneity of sensitivity, whereas number of liver lesions, prevalence of malignant liver lesions, blinded interpretation of SWE, and attrition rate were significantly associated with the heterogeneity of specificity (Additional file 1: Figure S1)
Summary
Shear wave elastography (SWE) imaging have been proposed for characterization of focal liver lesions. We conducted a meta-analysis to evaluate the accuracy and clinical utility of SWE imaging for differentiation of malignant and benign hepatic lesions. The development and extensive application of imaging technology has resulted in increased detection of focal liver lesions (FLLs) [1]. It is crucial to differentiate malignant from benign liver lesions, despite how extremely challenging that might be amid the wide variation of FLLs. Ultrasonography is commonly used as the first imaging technique for detecting and distinguishing focal liver lesions because of its availability, low cost, and safety. Liver biopsy has always been regarded as the gold standard for differentiating malignant and benign lesions. Liver biopsy is an invasive procedure and could give rise to several complications such as pain, bleeding, and risks of mortality [5, 6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
