Magnetic resonance elastography and acoustic radiation force impulse for staging hepatic fibrosis: a meta-analysis

Yang Guo, Sudharshan Parthasarathy, Preeya Goyal, Robert J. McCarthy, Andrew C. Larson, Frank H. Miller*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Purpose: 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. Materials and 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. Conclusion: MRE is more accurate than ARFI with a higher combination of sensitivity, specificity, LR, and AUROC particularly in diagnosing early stages of hepatic fibrosis.

Original languageEnglish (US)
Pages (from-to)818-834
Number of pages17
JournalAbdominal Imaging
Issue number4
StatePublished - Apr 8 2014


  • Acoustic radiation force impulse
  • Hepatic fibrosis
  • MR elastography
  • Magnetic resonance imaging
  • Meta-analysis

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology


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