TY - JOUR
T1 - Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease
T2 - a diagnostic accuracy systematic review and individual participant data pooled analysis
AU - Singh, Siddharth
AU - Venkatesh, Sudhakar K.
AU - Loomba, Rohit
AU - Wang, Zhen
AU - Sirlin, Claude
AU - Chen, Jun
AU - Yin, Meng
AU - Miller, Frank H.
AU - Low, Russell N.
AU - Hassanein, Tarek
AU - Godfrey, Edmund M.
AU - Asbach, Patrick
AU - Murad, Mohammad Hassan
AU - Lomas, David J.
AU - Talwalkar, Jayant A.
AU - Ehman, Richard L.
N1 - Funding Information:
The authors of this manuscript declare relationships with the following companies: This work is supported in part by National Institute of Health (NIH) grant EB001981 to MY, JC and RLE and American Gastroenterological Association (AGA) Foundation – Sucampo – ASP Designated Research Award in Geriatric Gastroenterology and by a T. Franklin Williams Scholarship Award and grant K23-DK090303-04 to RL. MY, JC, RLE and the Mayo Clinic have intellectual property relating to the subject and may be eligible for royalties from licensing. RLE is CEO of Resoundant, Inc. This research has been reviewed by the Mayo Clinic Conflict of Interest Review Board and is being conducted in compliance with Mayo Clinic Conflict of Interest policies. None of the other authors have any disclosures. This study received funding from the NIH to RL, MY and JC. Two of the authors have significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board.
Funding Information:
We wish to thank Ms. Patricia Erwin, M.L.S., Senior Medical Librarian at the Mayo Clinic Library for helping in the literature search for this systematic review and meta-analysis. The scientific guarantor of this publication is Sudhakar K. Venkatesh. The authors of this manuscript declare relationships with the following companies: This work is supported in part by National Institute of Health (NIH) grant EB001981 to MY, JC and RLE and American Gastroenterological Association (AGA) Foundation â Sucampo â ASP Designated Research Award in Geriatric Gastroenterology and by a T. Franklin Williams Scholarship Award and grant K23-DK090303-04 to RL. MY, JC, RLE and the Mayo Clinic have intellectual property relating to the subject and may be eligible for royalties from licensing. RLE is CEO of Resoundant, Inc. This research has been reviewed by the Mayo Clinic Conflict of Interest Review Board and is being conducted in compliance with Mayo Clinic Conflict of Interest policies. None of the other authors have any disclosures. This study received funding from the NIH to RL, MY and JC. Two of the authors have significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Some study subjects or cohorts have been previously reported in Singh S. et al. (2014) Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: A systematic review and meta-analysis of individual participant data. Clinical Gastroenterology and Hepatology 2015;13:440â451. Methodology: retrospective, observational, multicentre study.
Publisher Copyright:
© 2015, European Society of Radiology.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Objectives: We conducted an individual participant data (IPD) pooled analysis on diagnostic accuracy of MRE to detect fibrosis stage in patients with non-alcoholic fatty liver disease (NAFLD). Methods: Through a systematic literature search, we identified studies of MRE (at 60–62.5 Hz) for staging fibrosis in patients with NAFLD, using liver biopsy as gold standard, and contacted study authors for IPD. Through pooled analysis, we calculated the cluster-adjusted AUROC, sensitivity and specificity of MRE for any (≥stage 1), significant (≥stage 2) and advanced (≥stage 3) fibrosis and cirrhosis (stage 4). Results: We included nine studies with 232 patients with NAFLD (mean age, 51 ± 13 years; 37.5 % males; mean BMI, 33.5 ± 6.7 kg/m2; interval between MRE and biopsy <1 year, 98.3 %). Fibrosis stage distribution (stage 0/1/2/3/4) was 33.6, 32.3, 10.8, 12.9 and 10.4 %, respectively. Mean AUROC (and 95 % CIs) for diagnosis of any, significant or advanced fibrosis and cirrhosis was 0.86 (0.82–0.90), 0.87 (0.82–0.93), 0.90 (0.84–0.94) and 0.91 (0.76–0.95), respectively. Similar diagnostic performance was observed in stratified analysis based on sex, obesity and degree of inflammation. Conclusions: MRE has high diagnostic accuracy for detection of fibrosis in NAFLD, independent of BMI and degree of inflammation. Key points: • MRE has high diagnostic accuracy for detection of fibrosis in NAFLD. • BMI does not significantly affect accuracy of MRE in NAFLD. • Inflammation had no significant influence on MRE performance in NAFLD for fibrosis.
AB - Objectives: We conducted an individual participant data (IPD) pooled analysis on diagnostic accuracy of MRE to detect fibrosis stage in patients with non-alcoholic fatty liver disease (NAFLD). Methods: Through a systematic literature search, we identified studies of MRE (at 60–62.5 Hz) for staging fibrosis in patients with NAFLD, using liver biopsy as gold standard, and contacted study authors for IPD. Through pooled analysis, we calculated the cluster-adjusted AUROC, sensitivity and specificity of MRE for any (≥stage 1), significant (≥stage 2) and advanced (≥stage 3) fibrosis and cirrhosis (stage 4). Results: We included nine studies with 232 patients with NAFLD (mean age, 51 ± 13 years; 37.5 % males; mean BMI, 33.5 ± 6.7 kg/m2; interval between MRE and biopsy <1 year, 98.3 %). Fibrosis stage distribution (stage 0/1/2/3/4) was 33.6, 32.3, 10.8, 12.9 and 10.4 %, respectively. Mean AUROC (and 95 % CIs) for diagnosis of any, significant or advanced fibrosis and cirrhosis was 0.86 (0.82–0.90), 0.87 (0.82–0.93), 0.90 (0.84–0.94) and 0.91 (0.76–0.95), respectively. Similar diagnostic performance was observed in stratified analysis based on sex, obesity and degree of inflammation. Conclusions: MRE has high diagnostic accuracy for detection of fibrosis in NAFLD, independent of BMI and degree of inflammation. Key points: • MRE has high diagnostic accuracy for detection of fibrosis in NAFLD. • BMI does not significantly affect accuracy of MRE in NAFLD. • Inflammation had no significant influence on MRE performance in NAFLD for fibrosis.
KW - Biomarker
KW - Cirrhosis
KW - Diagnostic performance
KW - Elastography
KW - Fibrosis
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U2 - 10.1007/s00330-015-3949-z
DO - 10.1007/s00330-015-3949-z
M3 - Article
C2 - 26314479
AN - SCOPUS:84940069011
SN - 0938-7994
VL - 26
SP - 1431
EP - 1440
JO - European Radiology
JF - European Radiology
IS - 5
ER -
