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 L.
AU - Nakajima, Atsushi
AU - Loomba, Rohit
N1 - Funding Information:
Funding This study was funded by Atlantic Philanthropies , the John A. Hartford Foundation , OM , the Association of Specialty Professors , and the American Gastroenterological Association (grant no. K23-DK090303 ). Rohit Loomba is supported in part by the American Gastroenterological Association (AGA) Foundation–Sucampo–ASP Designated Research Award in Geriatric Gastroenterology and by a T. Franklin Williams Scholarship Award . Claude B. Sirlin and Rohit Loomba serve as co-PIs on grant no. R01-DK106419. Cyrielle Caussy is supported by grants from the Société Francophone du Diabète , the Philippe Foundation and Monahan Foundation under the Fulbright program. Meng Yin is supported by National Institutes of Health grant no. EB017197 . Richard L. Ehman is supported by National Institutes of Health grant no. EB001981 .
Publisher Copyright:
© 2019 AGA Institute
PY - 2019/3
Y1 - 2019/3
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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U2 - 10.1016/j.cgh.2018.05.059
DO - 10.1016/j.cgh.2018.05.059
M3 - Article
C2 - 29908362
AN - SCOPUS:85051072632
SN - 1542-3565
VL - 17
SP - 630-637.e8
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 4
ER -