E-resources
-
Selvaraj, Emmanuel Anandraj; 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 Padur; Romero-Gómez, Manuel; Tuthill, Theresa A.; Anstee, Quentin M.; Neubauer, Stefan; Harrison, Stephen A.; Bossuyt, Patrick M.; Pavlides, Michael; Anstee, Quentin; Daly, Ann; Johnson, Katherine; Cockell, Simon; Bedossa, Pierre; Oakley, Fiona; Cordell, Heather; Day, Chris; Wonders, Kristy; Zafarmand, Hadi; Vali, Yasaman; Lee, Jenny; Ratziu, Vlad; Pais, Raluca; Schattenberg, Jörn; Vidal-Puig, Toni; Vacca, Michele; Rodrigues-Cuenca, Sergio; Allison, Mike; Kamzolas, Ioannis; Hyötyläinen, Tuulia; McGlinchey, Aiden; Mato, Jose M.; Millet, Oscar; Dufour, Jean-François; Berzigotti, Annalisa; Pavlides, Michael; Harrison, Stephen; Neubauer, Stefan; Cobbold, Jeremy; Mozes, Ferenc; Akhtar, Salma; Banerjee, Rajarshi; Kelly, Matt; Erpicum, Charlotte; Romero-Gómez, Manuel; Gómez-González, Emilio; Ampuero, Javier; Gallego-Durán, Rocío; Fernández, Isabel; Montero-Vallejo, Rocío; Fisker, Mette Juul; Sinisi, Antonia; Musa, Kishwar; Sandt, Estelle; Tonini, Manuela; Rosso, Chiara; Armandi, Angelo; Marra, Fabio; Gastaldelli, Amalia; Svegliati, Gianluca; Francque, Sven; Vonghia, Luisa; Luukkonen, Panu; van Mil, Saskia; Papatheodoridis, George; Cortez-Pinto, Helena; Petta, Salvatore; Miele, Luca; Geier, Andreas; Aithal, Guru; Wenn, David; Pereira Rodrigues, Cecília Maria; Chaumat, Pierre; Ortiz, Pablo; Duffin, Kevin; Brosnan, Julia; Tuthill, Theresa; Ertle, Judith; Younes, Ramy; Ostroff, Rachel; Alexander, Leigh; Mikkelsen, Lars Friis; Balp, Maria-Magdalena; Jennings, Lori; Loeffler, Juergen; Hanauer, Guido; Fournier, Céline; Pepin, Kay; Ehman, Richard; Myers, Joel; Torstenson, Richard; Doward, Lynda
Journal of hepatology, 10/2021, Volume: 75, Issue: 4Journal Article
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). 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. 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. 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. 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. Display omitted •This is the largest systematic review of imaging/elastography biomarkers in NAFLD.•Meta-analysis of 1 MR elastography and 3 ultrasound techniques.•Elastography may help in fibrosis evaluation in those with NAFLD and valid readings.•Clinical utility of these tests cannot be assessed fully as intention-to-diagnose analyses and validation of pre-specified cut-offs are lacking.
Author
Shelf entry
Permalink
- URL:
Impact factor
Access to the JCR database is permitted only to users from Slovenia. Your current IP address is not on the list of IP addresses with access permission, and authentication with the relevant AAI accout is required.
Year | Impact factor | Edition | Category | Classification | ||||
---|---|---|---|---|---|---|---|---|
JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
Select the library membership card:
If the library membership card is not in the list,
add a new one.
DRS, in which the journal is indexed
Database name | Field | Year |
---|
Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
---|
Source: Personal bibliographies
and: SICRIS
The material is available in full text. If you wish to order the material anyway, click the Continue button.