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Meta‐analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis
Author(s) -
Bota Simona,
Herkner Harald,
Sporea Ioan,
Salzl Petra,
Sirli Roxana,
Neghina Adriana M.,
PeckRadosavljevic Markus
Publication year - 2013
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12240
Subject(s) - transient elastography , elastography , medicine , liver fibrosis , fibrosis , radiology , pathology , ultrasound
Aims This meta‐analysis aims to compare the diagnostic performance of acoustic radiation force impulse ( ARFI ) elastography and transient elastography ( TE ) in the assessment of liver fibrosis using liver biopsy (LB) as ‘gold‐standard’. Methods PubMed, Medline, Lilacs, Scopus, Ovid, EMBASE , Cochrane and Medscape databases were searched for all studies published until 31 May 2012 that evaluated the liver stiffness by means of ARFI , TE and LB. Information abstracted from each study according to a fixed protocol included study design and methodological characteristics, patient characteristics, interventions, outcomes and missing outcome data. Results Thirteen studies (11 full‐length articles and 2 abstracts) including 1163 patients with chronic hepatopathies were included in the analysis. Inability to obtain reliable measurements was more than thrice as high for TE as that of ARFI (6.6% vs. 2.1%, P < 0.001). For detection of significant fibrosis, ( F ≥ 2) the summary sensitivity (Se) was 0.74 (95% CI: 0.66–0.80) and specificity (Sp) was 0.83 (95% CI: 0.75–0.89) for ARFI, while for TE the Se was 0.78 (95% CI: 0.72–0.83) and Sp was 0.84 (95% CI: 0.75–0.90). For the diagnosis of cirrhosis, the summary Se was 0.87 (95% CI: 0.79–0.92) and Sp was 0.87 (95% CI: 0.81–0.91) for ARFI elastography, and, respectively, 0.89 (95% CI: 0.80–0.94) and 0.87 (95% CI: 0.82–0.91) for TE. The diagnostic odds ratio of ARFI and TE did not differ significantly in the detection of significant fibrosis [mean difference in rDOR = 0.27 (95% CI: 0.69–0.14)] and cirrhosis [mean difference in rDOR = 0.12 (95% CI: 0.29–0.52)]. Conclusion Acoustic radiation force impulse elastography seems to be a good method for assessing liver fibrosis, and shows higher rate of reliable measurements and similar predictive value to TE for significant fibrosis and cirrhosis.