Abstract
BackgroundWith the rapid development of real-time elastography (RTE), a variety of measuring methods have been developed for the assessment of hepatic fibrosis. We evaluated the overall performance of four methods based on RTE by performing meta-analysis of published literature.MethodsOnline journal databases and a manual search from April 2000 to April 2014 were used. Studies from different databases that meet inclusion criteria were enrolled. The statistical analysis was performed using a random-effects model and fixed-effects model for the overall effectiveness of RTE. The area under the receiver operating characteristic curve (AUROC) was calculated for various means. Fagan plot analysis was used to estimate the clinical utility of RTE, and the heterogeneity of the studies was explored with meta-regression analysis.ResultsThirteen studies from published articles were enrolled and analyzed. The combined AUROC of the liver fibrosis index (LFI) for the evaluation of significant fibrosis (F≥2), advanced fibrosis (F≥3), and cirrhosis (F = 4) were 0.79, 0.94, and 0.85, respectively. The AUROC of the elasticity index (EI) ranged from 0.75 to 0.92 for F≥2 and 0.66 to 0.85 for F = 4. The overall AUROC of the elastic ratio of the liver for the intrahepatic venous vessels were 0.94, 0.93, and 0.96, respectively. The AUROC of the elastic ratio of the liver for the intercostal muscle in diagnosing advanced fibrosis and cirrhosis were 0.96 and 0.92, respectively. There was significant heterogeneity in the diagnostic odds ratio (DOR) for F≥2 of LFI mainly due to etiology (p<0.01).ConclusionThe elastic ratio of the liver for the intrahepatic vein has excellent precision in differentiating each stage of hepatic fibrosis and is recommend to be applied to the clinic.
Highlights
The elastic ratio of the liver for the intrahepatic vein has excellent precision in differentiating each stage of hepatic fibrosis and is recommend to be applied to the clinic
Hepatic fibrosis, which occurs in patients suffering from chronic liver diseases (CLDs), is a pathological process [1] that is characterized by an accumulation of extracellular matrix (ECM)
With regard to ER1, the results showed that the negative post-probabilities of significant fibrosis (F$2) were 5%, 14%, and 32%, respectively, and the possibility of a precise diagnosis for patients with positive results ranged from 73% to 96% when the pre-test probability was 25%, 50%, 75% (S3 Figure)
Summary
Hepatic fibrosis, which occurs in patients suffering from chronic liver diseases (CLDs), is a pathological process [1] that is characterized by an accumulation of extracellular matrix (ECM). Non-invasive methods have been proposed to assess the severity of hepatic fibrosis as alternatives to biopsy [11, 12], including serum biomarkers, scoring systems and image examination. Among these non-invasive methods, ultrasound elastography which measures the stiffness of the liver related to hepatic fibrosis [13], has been explored. The combined AUROC of the liver fibrosis index (LFI) for the evaluation of significant fibrosis (F$2), advanced fibrosis (F$3), and cirrhosis (F54) were 0.79, 0.94, and 0.85, respectively. The AUROC of the elastic ratio of the liver for the intercostal muscle in diagnosing advanced fibrosis and cirrhosis were 0.96 and 0.92, respectively. There was significant heterogeneity in the diagnostic odds ratio (DOR) for F$2 of LFI mainly due to etiology (p,0.01)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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.
