Magnetic Resonance vs Transient Elastography Analysis of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Pooled Analysis of Individual Participants

Cynthia Hsu, Cyrielle Caussy, Kento Imajo, Jun Chen, Siddharth Singh, Kellee Kaulback, Minh Da Le, Jonathan Hooker, Xin Tu, Ricki Bettencourt, Meng Yin, Claude B. Sirlin, Richard Lorne Ehman, Atsushi Nakajima, Rohit Loomba

Research output: Contribution to journalArticle

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Abstract

Background & Aims: Magnetic resonance elastography (MRE) and transient elastography (TE) are noninvasive techniques for detection of liver fibrosis. Single-center studies have compared the diagnostic performance of MRE vs TE in patients with nonalcoholic fatty liver disease (NAFLD). We conducted a pooled analysis of individual participant data from published studies to compare the diagnostic performance of MRE vs TE for staging of liver fibrosis in patients with NAFLD, using liver biopsy as reference. Methods: We performed a systematic search of publication databases, from 2005 through 2017. We identified 3 studies of adults with NAFLD who were assessed by MRE, TE, and liver biopsy. In a pooled analysis, we calculated the cluster-adjusted area under the curve (AUROC) of MRE and TE for the detection of each stage of fibrosis. AUROC comparisons between MRE and TE were performed using the Delong test. Results: Our pooled analysis included 230 participants with biopsy-proven NAFLD with mean age of 52.2±13.9 years and a body mass index of 31.9±7.5 kg/m2. The proportions of patients with fibrosis of stages 0, 1, 2, 3, and 4 were: 31.7%, 27.8%, 15.7%, 13.9%, and 10.9%, respectively. The AUROC of TE vs MRE for detection of fibrosis stages ≥1 was 0.82 (95% CI, 0.76–0.88) vs 0.87 (95% CI, 0.82–0.91) (P=.04); for stage≥ 2 was 0.87 (95% CI, 0.82–0.91) vs 0.92 (95% CI, 0.88–0.96) (P=.03); for stage ≥3 was 0.84 (95% CI, 0.78–0.90) vs 0.93 (95% CI, 0.89–0.96) (P=.001); for stage ≥ 4 was 0.84 (95% CI, 0.73–0.94) vs 0.94 (95% CI, 0.89–0.99) (P=.005). Conclusion: In a pooled analysis of data from individual participants with biopsy-proven NAFLD, we found MRE to have a statistically significantly higher diagnostic accuracy than TE in detection of each stage of fibrosis. MRE and TE each have roles in detection of fibrosis in patients with NAFLD, depending upon the level of accuracy desired.

Original languageEnglish (US)
Pages (from-to)630-637.e8
JournalClinical Gastroenterology and Hepatology
Volume17
Issue number4
DOIs
StatePublished - Mar 1 2019

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Elasticity Imaging Techniques
Magnetic Resonance Spectroscopy
Fibrosis
Biopsy
Non-alcoholic Fatty Liver Disease
Liver Cirrhosis

Keywords

  • Fibroscan
  • Magnetic Resonance Elastography
  • NAFLD
  • Transient Elastography

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Magnetic Resonance vs Transient Elastography Analysis of Patients With Nonalcoholic Fatty Liver Disease : A Systematic Review and Pooled Analysis of Individual Participants. / Hsu, Cynthia; Caussy, Cyrielle; Imajo, Kento; Chen, Jun; Singh, Siddharth; Kaulback, Kellee; Le, Minh Da; Hooker, Jonathan; Tu, Xin; Bettencourt, Ricki; Yin, Meng; Sirlin, Claude B.; Ehman, Richard Lorne; Nakajima, Atsushi; Loomba, Rohit.

In: Clinical Gastroenterology and Hepatology, Vol. 17, No. 4, 01.03.2019, p. 630-637.e8.

Research output: Contribution to journalArticle

Hsu, C, Caussy, C, Imajo, K, Chen, J, Singh, S, Kaulback, K, Le, MD, Hooker, J, Tu, X, Bettencourt, R, Yin, M, Sirlin, CB, Ehman, RL, Nakajima, A & Loomba, R 2019, 'Magnetic Resonance vs Transient Elastography Analysis of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Pooled Analysis of Individual Participants', Clinical Gastroenterology and Hepatology, vol. 17, no. 4, pp. 630-637.e8. https://doi.org/10.1016/j.cgh.2018.05.059
Hsu, Cynthia ; Caussy, Cyrielle ; Imajo, Kento ; Chen, Jun ; Singh, Siddharth ; Kaulback, Kellee ; Le, Minh Da ; Hooker, Jonathan ; Tu, Xin ; Bettencourt, Ricki ; Yin, Meng ; Sirlin, Claude B. ; Ehman, Richard Lorne ; Nakajima, Atsushi ; Loomba, Rohit. / Magnetic Resonance vs Transient Elastography Analysis of Patients With Nonalcoholic Fatty Liver Disease : A Systematic Review and Pooled Analysis of Individual Participants. In: Clinical Gastroenterology and Hepatology. 2019 ; Vol. 17, No. 4. pp. 630-637.e8.
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abstract = "Background & Aims: Magnetic resonance elastography (MRE) and transient elastography (TE) are noninvasive techniques for detection of liver fibrosis. Single-center studies have compared the diagnostic performance of MRE vs TE in patients with nonalcoholic fatty liver disease (NAFLD). We conducted a pooled analysis of individual participant data from published studies to compare the diagnostic performance of MRE vs TE for staging of liver fibrosis in patients with NAFLD, using liver biopsy as reference. Methods: We performed a systematic search of publication databases, from 2005 through 2017. We identified 3 studies of adults with NAFLD who were assessed by MRE, TE, and liver biopsy. In a pooled analysis, we calculated the cluster-adjusted area under the curve (AUROC) of MRE and TE for the detection of each stage of fibrosis. AUROC comparisons between MRE and TE were performed using the Delong test. Results: Our pooled analysis included 230 participants with biopsy-proven NAFLD with mean age of 52.2±13.9 years and a body mass index of 31.9±7.5 kg/m2. The proportions of patients with fibrosis of stages 0, 1, 2, 3, and 4 were: 31.7{\%}, 27.8{\%}, 15.7{\%}, 13.9{\%}, and 10.9{\%}, respectively. The AUROC of TE vs MRE for detection of fibrosis stages ≥1 was 0.82 (95{\%} CI, 0.76–0.88) vs 0.87 (95{\%} CI, 0.82–0.91) (P=.04); for stage≥ 2 was 0.87 (95{\%} CI, 0.82–0.91) vs 0.92 (95{\%} CI, 0.88–0.96) (P=.03); for stage ≥3 was 0.84 (95{\%} CI, 0.78–0.90) vs 0.93 (95{\%} CI, 0.89–0.96) (P=.001); for stage ≥ 4 was 0.84 (95{\%} CI, 0.73–0.94) vs 0.94 (95{\%} CI, 0.89–0.99) (P=.005). Conclusion: In a pooled analysis of data from individual participants with biopsy-proven NAFLD, we found MRE to have a statistically significantly higher diagnostic accuracy than TE in detection of each stage of fibrosis. MRE and TE each have roles in detection of fibrosis in patients with NAFLD, depending upon the level of accuracy desired.",
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author = "Cynthia Hsu and Cyrielle Caussy and Kento Imajo and Jun Chen and Siddharth Singh and Kellee Kaulback and Le, {Minh Da} and Jonathan Hooker and Xin Tu and Ricki Bettencourt and Meng Yin and Sirlin, {Claude B.} and Ehman, {Richard Lorne} and Atsushi Nakajima and Rohit Loomba",
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TY - JOUR

T1 - Magnetic Resonance vs Transient Elastography Analysis of Patients With Nonalcoholic Fatty Liver Disease

T2 - A Systematic Review and Pooled Analysis of Individual Participants

AU - Hsu, Cynthia

AU - Caussy, Cyrielle

AU - Imajo, Kento

AU - Chen, Jun

AU - Singh, Siddharth

AU - Kaulback, Kellee

AU - Le, Minh Da

AU - Hooker, Jonathan

AU - Tu, Xin

AU - Bettencourt, Ricki

AU - Yin, Meng

AU - Sirlin, Claude B.

AU - Ehman, Richard Lorne

AU - Nakajima, Atsushi

AU - Loomba, Rohit

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background & Aims: Magnetic resonance elastography (MRE) and transient elastography (TE) are noninvasive techniques for detection of liver fibrosis. Single-center studies have compared the diagnostic performance of MRE vs TE in patients with nonalcoholic fatty liver disease (NAFLD). We conducted a pooled analysis of individual participant data from published studies to compare the diagnostic performance of MRE vs TE for staging of liver fibrosis in patients with NAFLD, using liver biopsy as reference. Methods: We performed a systematic search of publication databases, from 2005 through 2017. We identified 3 studies of adults with NAFLD who were assessed by MRE, TE, and liver biopsy. In a pooled analysis, we calculated the cluster-adjusted area under the curve (AUROC) of MRE and TE for the detection of each stage of fibrosis. AUROC comparisons between MRE and TE were performed using the Delong test. Results: Our pooled analysis included 230 participants with biopsy-proven NAFLD with mean age of 52.2±13.9 years and a body mass index of 31.9±7.5 kg/m2. The proportions of patients with fibrosis of stages 0, 1, 2, 3, and 4 were: 31.7%, 27.8%, 15.7%, 13.9%, and 10.9%, respectively. The AUROC of TE vs MRE for detection of fibrosis stages ≥1 was 0.82 (95% CI, 0.76–0.88) vs 0.87 (95% CI, 0.82–0.91) (P=.04); for stage≥ 2 was 0.87 (95% CI, 0.82–0.91) vs 0.92 (95% CI, 0.88–0.96) (P=.03); for stage ≥3 was 0.84 (95% CI, 0.78–0.90) vs 0.93 (95% CI, 0.89–0.96) (P=.001); for stage ≥ 4 was 0.84 (95% CI, 0.73–0.94) vs 0.94 (95% CI, 0.89–0.99) (P=.005). Conclusion: In a pooled analysis of data from individual participants with biopsy-proven NAFLD, we found MRE to have a statistically significantly higher diagnostic accuracy than TE in detection of each stage of fibrosis. MRE and TE each have roles in detection of fibrosis in patients with NAFLD, depending upon the level of accuracy desired.

AB - Background & Aims: Magnetic resonance elastography (MRE) and transient elastography (TE) are noninvasive techniques for detection of liver fibrosis. Single-center studies have compared the diagnostic performance of MRE vs TE in patients with nonalcoholic fatty liver disease (NAFLD). We conducted a pooled analysis of individual participant data from published studies to compare the diagnostic performance of MRE vs TE for staging of liver fibrosis in patients with NAFLD, using liver biopsy as reference. Methods: We performed a systematic search of publication databases, from 2005 through 2017. We identified 3 studies of adults with NAFLD who were assessed by MRE, TE, and liver biopsy. In a pooled analysis, we calculated the cluster-adjusted area under the curve (AUROC) of MRE and TE for the detection of each stage of fibrosis. AUROC comparisons between MRE and TE were performed using the Delong test. Results: Our pooled analysis included 230 participants with biopsy-proven NAFLD with mean age of 52.2±13.9 years and a body mass index of 31.9±7.5 kg/m2. The proportions of patients with fibrosis of stages 0, 1, 2, 3, and 4 were: 31.7%, 27.8%, 15.7%, 13.9%, and 10.9%, respectively. The AUROC of TE vs MRE for detection of fibrosis stages ≥1 was 0.82 (95% CI, 0.76–0.88) vs 0.87 (95% CI, 0.82–0.91) (P=.04); for stage≥ 2 was 0.87 (95% CI, 0.82–0.91) vs 0.92 (95% CI, 0.88–0.96) (P=.03); for stage ≥3 was 0.84 (95% CI, 0.78–0.90) vs 0.93 (95% CI, 0.89–0.96) (P=.001); for stage ≥ 4 was 0.84 (95% CI, 0.73–0.94) vs 0.94 (95% CI, 0.89–0.99) (P=.005). Conclusion: In a pooled analysis of data from individual participants with biopsy-proven NAFLD, we found MRE to have a statistically significantly higher diagnostic accuracy than TE in detection of each stage of fibrosis. MRE and TE each have roles in detection of fibrosis in patients with NAFLD, depending upon the level of accuracy desired.

KW - Fibroscan

KW - Magnetic Resonance Elastography

KW - NAFLD

KW - Transient Elastography

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