Noninvasive Assessment of Liver Fibrosis Stage Using Ultrasound‐Based Shear Wave Velocity Measurements and Serum Algorithms in Patients With Viral Hepatitis B: A Retrospective Cohort Study

Liu, Jianxue; Zhao, Junzhi; Zhang, Yaoren; Ji, Yonghao; Su, Lin; Dun, Guoliang; Guo, Sujuan

doi:10.7863/ultra.16.01069

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…A total of 2831 studies were searched by the described search strategies, of which 2627 were excluded following title and abstract screening. Of those, 81 papers were included in the review following full-text screening (Text S5); 47 studies were related to the APRI[24-70], 11 to the ARFI[29,42,69-77], 32 to the FIB-4[24,25,27,30,35,36,39,40,43-46,48-55,57,58,60,62,63,65-69,78-79], 29 to the FibroScan[28,38,42,52,53,58,60,61,71,73,80-98], and 6 to the MRE[99-104].…”

Section: Resultsmentioning

confidence: 99%

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Xue¹,

Wang²,

Zhang³

et al. 2019

WJCC

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BACKGROUND Noninvasive biomarkers have been developed to predict hepatitis B virus (HBV) related fibrosis owing to the significant limitations of liver biopsy. Both serum biomarkers and imaging techniques have shown promising results and may improve the evaluation of liver fibrosis. However, most of the previous studies focused on the diagnostic effects of various imaging techniques on fibrosis in all chronic liver diseases. AIM To compare the performance of common imaging methods and serum biomarkers for prediction of significant fibrosis caused only by HBV infection. METHODS A systematic review was conducted on the records available in PubMed, EMBASE, and the Cochrane Library electronic databases until December 2018. We systematically assessed the effectiveness of two serum biomarkers and three imagine techniques in predicting significant fibrosis solely caused by HBV infection. The serum biomarkers included aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the 4 factors (FIB-4). The three imaging techniques included acoustic radiation force impulse (ARFI), FibroScan, and magnetic resonance elastography (MRE). Three parameters, the area under the summary receiver operating characteristic curve (AUSROC), the summary diagnostic odds ratio, and the summary sensitivity and specificity, were used to examine the accuracy of all tests for liver fibrosis. RESULTS Out of 2831 articles evaluated for eligibility, 204 satisfied the predetermined inclusion criteria for this current meta-analysis. Eventually, our final data contained 81 studies. The AUSROCs of serum biomarkers of APRI and FIB-4 were both 0.75. For imaging techniques (ARFI, FibroScan, and MRE), the areas were 0.89, 0.83, and 0.97, respectively. The heterogeneities of ARFI and FibroScan were statistically significant ( I 2 > 50%). The publication bias was not observed in any of the serum biomarkers or imaging methods. CONCLUSION These five methods have attained an acceptable level of diagnostic accuracy. Imaging techniques, MRE in particular, demonstrate significant advantages in accurately predicting HBV-related significant fibrosis, while serum biomarkers are admissible methods.

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Section: Resultsmentioning

confidence: 99%

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Xue¹,

Wang²,

Zhang³

et al. 2019

WJCC

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“…[16][17][18] Noninvasive fibrosis scores including aspartate transaminase to platelet ratio index (APRI) and fibrosis index based on the 4 factors (FIB-4) utilize a combination of standard of care laboratory tests and have been studied extensively in both adults and children with good accuracy in staging liver fibrosis. [19][20][21][22][23][24][25][26] Furthermore, many novel serum biomarkers are involved in extracellular matrix formation or degradation, inflammation, or hepatocellular damage. Studies of these biomarkers in pediatric patients with biliary atresia, nonalcoholic fatty liver disease, cystic fibrosis-associated liver disease, and adults with chronic viral hepatitis show promise for accurately staging liver fibrosis.…”

Section: Introductionmentioning

confidence: 99%

A Liver Biopsy Validation Pilot Study of Shear Wave Elastography, APRI, FIB-4, and Novel Serum Biomarkers for Liver Fibrosis Staging in Children With Chronic Viral Hepatitis

Mercedes

Brown

Minard

et al. 2020

Global Pediatric Health

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As liver biopsy in children poses inherent risks, noninvasive measures of liver fibrosis are needed. This was a cross-sectional, liver biopsy validation pilot study of 16 participants evaluating the ability of shear wave elastography, aspartate transaminase to platelet ratio index (APRI), fibrosis index based on the 4 factors, and novel serum biomarkers to stage liver fibrosis in children with chronic hepatitis B or C. There was very high intrasegmental shear wave speed variation in our participants and little correlation with fibrosis. APRI and monocyte chemoattractant protein (MCP-1) were higher in fibrosis stage F2-3 versus F0-1 ( P = .02, P = .06, respectively). Soluble Fas (sFas) was lower in F2-3 versus F0-1 ( P = .046). A logistic regression analysis calculated by (APRI × MCP-1)/sFas demonstrated an area under the receiver operating characteristic curve of 0.92 ( P < .001), suggesting that this combination can differentiate fibrosis stage F0-1 from F2-3 in children with chronic viral hepatitis.

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“…Most of the studies were conducted in European countries, followed by Asian countries. There were a total of three in Italy [19][20][21], four in Romania [22][23][24][25], two in France [26][27][28], one in Spain [29], one in Indonesia [30], and two German [31,32], two in Brazil [33,34], one in United State [35], seven in China [36][37][38][39][40][41][42], three in Japan [43][44][45], one in Egypt [46], and one in South Korea [47]. Many of the studies were prospective in design and performed in a single center.…”

Section: Plos Onementioning

confidence: 99%

Diagnostic accuracy of magnetic resonance elastography and point-shear wave elastography for significant hepatic fibrosis screening: Systematic review and meta-analysis

et al. 2023

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The hepatic diseases are extremely common in clinical practice. The correct classification of liver fibrosis is extremely important, as it influences therapy and predicts disease outcomes. The purpose of this study is to compare the diagnostic performance of point-shear wave elastography (pSWE) and magnetic resonance elastography (MRE) in the hepatic fibrosis diagnostic. A meta-analysis was carried out based on articles published until October 2020. The articles are available at following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, LILACS, Scopus, and CINAHL. Diagnostic performances were analyzed per METAVIR F2, using 3.5kPa as target fibrosis. Assessment of the methodological quality of the incorporated papers by the QUADAS-2 tool for pSWE and MRE. A total 2,153 studies articles were evaluated and 44 studies, comprising 6,081 patients with individual data, were included in the meta-analysis: 28 studies for pSWE and 16 studies for MRE. The pooled sensitivity and specificity were 0.86 (95%CI 0.80–0.90) and 0.88 (95%CI 0.85–0.91), respectively, for pSWE, compared with 0.94 (95%CI 0.89–0.97) and 0.95 (95%CI 0.89–0.98) respectively, for MRE. The pooled SROC curve for pSWE shows in the area under the curve (AUC) of 0.93 (95%CI 0.90–0.95), whereas the AUC for MRE was 0.98 (95%CI 0.96–0.99). The diagnostic odds ratio for pSWE and MRE were 41 (95%CI 24–72) and 293 (95%CI 86–1000), respectively. There was statistically significant heterogeneity for pSWE sensitivity (I² = 85.26, P<0.001) and specificity (I² = 89.46, P<0.001). The heterogeneity for MRE also was significant for sensitivity (I² = 73.28, P<0.001) and specificity (I² = 87.24, P<0.001). Therefore, both pSWE and MRE are suitable modalities for assessing liver fibrosis. In addition, MRE is a more accurate imaging technique than pSWE and can be used as alternative to invasive biopsy.

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Noninvasive Assessment of Liver Fibrosis Stage Using Ultrasound‐Based Shear Wave Velocity Measurements and Serum Algorithms in Patients With Viral Hepatitis B: A Retrospective Cohort Study

Abstract: The SWV, APRI, and FIB-4 were valid tests for evaluating substantial liver fibrosis and cirrhosis. The combination of these tests with several noninvasive indicators is expected to enhance the assessment of liver fibrosis stages.

Cited by 9 publications

References 26 publications

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

A Liver Biopsy Validation Pilot Study of Shear Wave Elastography, APRI, FIB-4, and Novel Serum Biomarkers for Liver Fibrosis Staging in Children With Chronic Viral Hepatitis

Diagnostic accuracy of magnetic resonance elastography and point-shear wave elastography for significant hepatic fibrosis screening: Systematic review and meta-analysis

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