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Performance of Real-Time Elastography for the Staging of Hepatic Fibrosis: A Meta-Analysis

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  • Huisuo Hong
  • Jia Li
  • Yin Jin
  • Qiao Li
  • Weimin Li
  • Jiansheng Wu
  • Zhiming Huang

Abstract

Background: With the rapid development of real-time elastography (RTE), a variety of measuring methods have been developed for the assessment of hepatic fibrosis. We evaluated the overall performance of four methods based on RTE by performing meta-analysis of published literature. Methods: Online journal databases and a manual search from April 2000 to April 2014 were used. Studies from different databases that meet inclusion criteria were enrolled. The statistical analysis was performed using a random-effects model and fixed-effects model for the overall effectiveness of RTE. The area under the receiver operating characteristic curve (AUROC) was calculated for various means. Fagan plot analysis was used to estimate the clinical utility of RTE, and the heterogeneity of the studies was explored with meta-regression analysis. Results: Thirteen studies from published articles were enrolled and analyzed. The combined AUROC of the liver fibrosis index (LFI) for the evaluation of significant fibrosis (F≥2), advanced fibrosis (F≥3), and cirrhosis (F = 4) were 0.79, 0.94, and 0.85, respectively. The AUROC of the elasticity index (EI) ranged from 0.75 to 0.92 for F≥2 and 0.66 to 0.85 for F = 4. The overall AUROC of the elastic ratio of the liver for the intrahepatic venous vessels were 0.94, 0.93, and 0.96, respectively. The AUROC of the elastic ratio of the liver for the intercostal muscle in diagnosing advanced fibrosis and cirrhosis were 0.96 and 0.92, respectively. There was significant heterogeneity in the diagnostic odds ratio (DOR) for F≥2 of LFI mainly due to etiology (p

Suggested Citation

  • Huisuo Hong & Jia Li & Yin Jin & Qiao Li & Weimin Li & Jiansheng Wu & Zhiming Huang, 2014. "Performance of Real-Time Elastography for the Staging of Hepatic Fibrosis: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-15, December.
    • Handle: RePEc:plo:pone00:0115702
    DOI: 10.1371/journal.pone.0115702
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    References listed on IDEAS

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    1. Young Eun Chon & Eun Hee Choi & Ki Jun Song & Jun Yong Park & Do Young Kim & Kwang-Hyub Han & Chae Yoon Chon & Sang Hoon Ahn & Seung Up Kim, 2012. "Performance of Transient Elastography for the Staging of Liver Fibrosis in Patients with Chronic Hepatitis B: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(9), pages 1-7, September.
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