title: Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis.
abstract: Two-dimensional shear wave elastography (2D-SWE) has proven to be efficient for the evaluation of liver fibrosis in small to moderate-sized clinical trials. We aimed at running a larger-scale meta-analysis of individual data. Centers which have worked with Aixplorer ultrasound equipment were contacted to share their data. Retrospective statistical analysis used direct and paired receiver operating characteristic and area under the receiver operating characteristic curve (AUROC) analyses, accounting for random effects. Data on both 2D-SWE and liver biopsy were available for 1,134 patients from 13 sites, as well as on successful transient elastography in 665 patients. Most patients had chronic hepatitis C (n = 379), hepatitis B (n = 400), or nonalcoholic fatty liver disease (n = 156). AUROCs of 2D-SWE in patients with hepatitis C, hepatitis B, and nonalcoholic fatty liver disease were 86.3%, 90.6%, and 85.5% for diagnosing significant fibrosis and 92.9%, 95.5%, and 91.7% for diagnosing cirrhosis, respectively. The AUROC of 2D-SWE was 0.022-0.084 (95% confidence interval) larger than the AUROC of transient elastography for diagnosing significant fibrosis (P = 0.001) and 0.003-0.034 for diagnosing cirrhosis (P = 0.022) in all patients. This difference was strongest in hepatitis B patients.
  
  
  
  2D-SWE has good to excellent performance for the noninvasive staging of liver fibrosis in patients with hepatitis B; further prospective studies are needed for head-to-head comparison between 2D-SWE and other imaging modalities to establish disease-specific appropriate cutoff points for assessment of fibrosis stage. (Hepatology 2018;67:260-272).
authors.affiliation: Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
authors.affiliation: Hepatology Unit, Centre Hospitalier Universitaire, Bordeaux, France.|INSERM U1053, Bordeaux University, Bordeaux, France.
authors.forename: Victor
authors.initials: V
authors.lastname: de Lédinghen
authors.affiliation: Department of Diagnostic and Interventional Imaging, Centre Hospitalier Universitaire du Haut-Lévèque, Bordeaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Cassinotto
authors.affiliation: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Winnie C-W
authors.initials: WC
authors.lastname: Chu
authors.affiliation: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Vivian Y-F
authors.initials: VY
authors.lastname: Leung
authors.affiliation: Infectious Diseases Department, Ultrasound Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Ferraioli
authors.affiliation: Infectious Diseases Department, Ultrasound Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Filice
authors.affiliation: Department of Hepatology, Assistance Publique de Hôpitaux de ParisHôpital Universitaire Beaujon, Clichy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Castera
authors.affiliation: Department of Radiology, Assistance Publique de Hôpitaux de Paris, Hôpital Universitaire Beaujon, Clichy, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.affiliation: Department of Radiology, Assistance Publique de Hôpitaux de Paris, Hôpital Universitaire Beaujon, Clichy, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.affiliation: Department of Hepatology, Hospices Civils de Lyon, Hôpital Universitaire Edouard Herriot, Lyon, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dumortier
authors.affiliation: Department of Radiology, Centre Hospitalier Général de Perpignan, Perpignan, France.
authors.forename: Aymeric
authors.initials: A
authors.lastname: Guibal
authors.affiliation: Department of Hepatology, Assistance Publique de Hôpitaux de Paris, Hôpital Cochin, and Université Paris Descartes and INSERM UMS20, Institut Pasteur, Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.affiliation: Department of Internal Medicine I, Universitätsklinikum Bonn, Bonn, Germany.|Research Unit for Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.|European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain.
authors.forename: Jonel
authors.initials: J
authors.lastname: Trebicka
authors.affiliation: Department of Internal Medicine I, Universitätsklinikum Bonn, Bonn, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Jansen
authors.affiliation: Department of Internal Medicine I, Universitätsklinikum Bonn, Bonn, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Strassburg
authors.affiliation: Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Rongqin
authors.initials: R
authors.lastname: Zheng
authors.affiliation: Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Division of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Sven
authors.initials: S
authors.lastname: Francque
authors.affiliation: Division of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Vanwolleghem
authors.affiliation: Division of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Luisa
authors.initials: L
authors.lastname: Vonghia
authors.affiliation: Department of Internal Medicine, Athens University School of Medicine, Athens, Greece.
authors.forename: Emanuel K
authors.initials: EK
authors.lastname: Manesis
authors.affiliation: Department of Radiology, Athens University School of Medicine, Athens, Greece.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Zoumpoulis
authors.affiliation: Department of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.affiliation: Research Unit for Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.
authors.forename: Maja
authors.identifier: 0000-0003-1854-1924
authors.initials: M
authors.lastname: Thiele
authors.affiliation: Research Unit for Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Krag
authors.affiliation: SuperSonic Imagine, Aix-en-Provence, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Cohen-Bacrie
authors.affiliation: SuperSonic Imagine, Aix-en-Provence, France.
authors.forename: Aline
authors.initials: A
authors.lastname: Criton
authors.affiliation: SuperSonic Imagine, Aix-en-Provence, France.
authors.forename: Joel
authors.initials: J
authors.lastname: Gay
authors.affiliation: INSERM U979-Institut Langevin-ESPCI ParisTec, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Deffieux
authors.affiliation: Department of Internal Medicine, Goethe University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Mireen
authors.initials: M
authors.lastname: Friedrich-Rust
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D016208:Databases, Factual; D018450:Disease Progression; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult