Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease

a diagnostic accuracy systematic review and individual participant data pooled analysis

Siddharth Singh, Sudhakar K Venkatesh, Rohit Loomba, Zhen Wang, Claude Sirlin, Jun Chen, Meng Yin, Frank H. Miller, Russell N. Low, Tarek Hassanein, Edmund M. Godfrey, Patrick Asbach, Mohammad H Murad, David J. Lomas, Jayant A. Talwalkar, Richard Lorne Ehman

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

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/m<sup>2</sup>; 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.

Original languageEnglish (US)
JournalEuropean Radiology
DOIs
StateAccepted/In press - Aug 28 2015

Fingerprint

Elasticity Imaging Techniques
Liver Cirrhosis
Fibrosis
Inflammation
Biopsy
Non-alcoholic Fatty Liver Disease
Cluster Analysis
Obesity
Sensitivity and Specificity

Keywords

  • Biomarker
  • Cirrhosis
  • Diagnostic performance
  • Elastography
  • Fibrosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease : a diagnostic accuracy systematic review and individual participant data pooled analysis. / Singh, Siddharth; Venkatesh, Sudhakar K; Loomba, Rohit; Wang, Zhen; Sirlin, Claude; Chen, Jun; Yin, Meng; Miller, Frank H.; Low, Russell N.; Hassanein, Tarek; Godfrey, Edmund M.; Asbach, Patrick; Murad, Mohammad H; Lomas, David J.; Talwalkar, Jayant A.; Ehman, Richard Lorne.

In: European Radiology, 28.08.2015.

Research output: Contribution to journalArticle

Singh, Siddharth ; Venkatesh, Sudhakar K ; Loomba, Rohit ; Wang, Zhen ; Sirlin, Claude ; Chen, Jun ; Yin, Meng ; Miller, Frank H. ; Low, Russell N. ; Hassanein, Tarek ; Godfrey, Edmund M. ; Asbach, Patrick ; Murad, Mohammad H ; Lomas, David J. ; Talwalkar, Jayant A. ; Ehman, Richard Lorne. / Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease : a diagnostic accuracy systematic review and individual participant data pooled analysis. In: European Radiology. 2015.
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title = "Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis",
abstract = "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.",
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author = "Siddharth Singh and Venkatesh, {Sudhakar K} and Rohit Loomba and Zhen Wang and Claude Sirlin and Jun Chen and Meng Yin and Miller, {Frank H.} and Low, {Russell N.} and Tarek Hassanein and Godfrey, {Edmund M.} and Patrick Asbach and Murad, {Mohammad H} and Lomas, {David J.} and Talwalkar, {Jayant A.} and Ehman, {Richard Lorne}",
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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 H

AU - Lomas, David J.

AU - Talwalkar, Jayant A.

AU - Ehman, Richard Lorne

PY - 2015/8/28

Y1 - 2015/8/28

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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