Diagnostic Accuracy of 2D-Shear Wave Elastography for Liver Fibrosis Severity: A Meta-Analysis.
OBJECTIVE
To evaluate the accuracy of shear wave elastography (SWE) in the quantitative diagnosis of liver fibrosis severity.


METHODS
The published literatures were systematically retrieved from PubMed, Embase, Web of science and Scopus up to May 13th, 2016. Included studies reported the pooled sensitivity, specificity, positive and negative predictive values, as well as the diagnostic odds ratio of SWE in populations with liver fibrosis. A bivariate mixed-effects regression model was used, which was estimated by the I2 statistics. The quality of articles was evaluated by quality assessment of diagnostic accuracy studies (QUADAS).


RESULTS
Thirteen articles including 2303 patients were qualified for the study. The pooled sensitivity and specificity of SWE for the diagnosis of liver fibrosis are as follows: ≥F1 0.76 (p<0.001, 95% CI, 0.71-0.81, I2 = 75.33%), 0.92 (p<0.001, 95% CI, 0.80-0.97, I2 = 79.36%); ≥F2 0.84 (p = 0.35, 95% CI, 0.81-0.86, I2 = 9.55%), 0.83 (p<0.001, 95% CI, 0.77-0.88, I2 = 86.56%); ≥F3 0.89 (p = 0.56, 95% CI, 0.86-0.92, I2 = 0%), 0.86 (p<0.001, 95% CI, 0.82-0.90, I2 = 75.73%); F4 0.89 (p = 0.24, 95% CI, 0.84-0.92, I2 = 20.56%), 0.88 (p<0.001, 95% CI, 0.84-0.92, I2 = 82.75%), respectively. Sensitivity analysis showed no significant changes if any one of the studies was excluded. Publication bias was not detected in this meta-analysis.


CONCLUSIONS
Our study suggests that SWE is a helpful method to appraise liver fibrosis severity. Future studies that validate these findings would be appropriate.
Department of Ultrasonography, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Tian'an
T
Jiang
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Guo
G
Tian
Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Qiyu
Q
Zhao
Department of Mathematics, Zhejiang University, Hangzhou 310027, China.
Dexing
D
Kong
Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Chao
C
Cheng
Department of Ultrasonography, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Liyun
L
Zhong
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Lanjuan
L
Li
D019540:Area Under Curve; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012680:Sensitivity and Specificity