Magnetic resonance elastography and acoustic radiation force impulse for staging hepatic fibrosis: a meta-analysis.
OBJECTIVE
Elastography is a non-invasive method to quantify fibrosis based on tissue mechanical properties. We performed a meta-analysis to assess the diagnostic accuracy of two such techniques: Acoustic Radiation Force Impulse Imaging (ARFI) or Magnetic Resonance Elastography (MRE) for staging hepatic fibrosis.


METHODS
Literature databases were searched until June 2013. Inclusion criteria were evaluation of MRE or ARFI, liver biopsy, and reported sensitivity and specificity. A random effects model was used to combine sensitivity and specificity, from which positive (LR+) and negative (LR-) likelihood ratios, diagnostic odds ratios, and area under receiver operating characteristics curve (AUROC) were derived. Differences between MRE and ARFI were compared with t tests (P < 0.05 considered significant).


RESULTS
Eleven MRE studies including 982 patients and fifteen ARFI studies including 2,128 patients were selected. AUROC for MRE staging fibrosis were 0.94, 0.97, 0.96, and 0.97 for F1-F4, respectively, whereas AUROC for ARFI staging were 0.82, 0.85, 0.94, and 0.94 for F1-F4, respectively. Significance was found in AUROC between MRE and ARFI for the diagnosis of stage 1 and 2 fibrosis.


CONCLUSIONS
MRE is more accurate than ARFI with a higher combination of sensitivity, specificity, LR, and AUROC particularly in diagnosing early stages of hepatic fibrosis.
Department of Radiology, Northwestern University Feinberg School of Medicine, NMH/Arkes Family Pavilion Suite 800, 676 N Saint Clair, Chicago, IL, 60611, USA.
Yang
Y
Guo
Sudharshan
S
Parthasarathy
Preeya
P
Goyal
Robert J
RJ
McCarthy
Andrew C
AC
Larson
Frank H
FH
Miller
D019540:Area Under Curve; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index