Data from: Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis

Objective: This study aimed to assess the accuracy of staging liver fibrosis in Non-Alcoholic Fatty Liver Disease Patients (NAFLD) via Point shear wave Elastography (pSWE) and Transient Elastography (TE).
Setting: Relevant records concerning NAFLD were retrieved from Pubmed, Embase, Web of Science, and the China National Knowledge Infrastructure databases up to 20th of December, 2017. A bivariate mixed-effects model was conducted to combine sensitivity (SE), specificity (SP), positive likelihood ratio (LR+), negative likelihood ratio (LR-) and Area Under Summary Receiver Operating Characteristic Curve (AUC) between TE and pSWE. A sensitivity analysis was implemented to explore the source of heterogeneity.
Participants: Patients with NAFLD who had a liver stiffness measurement using pSWE and TE before liver biopsy were enrolled according to the following criteria : 2×2 contingency tables can be calculated via the reported numbers of cases, sensitivity and specificity and were excluded according to the following criteria: with histories of other hepatic damage, such as chronic hepatitis C, concurrent active hepatitis B infection, autoimmune hepatitis, suspicious drug usage, and alcohol abuse.
Results: Nine pSWE studies comprising a total 982 of patients and eleven TE studies comprising a total of 1753 patients were included. For detection of significant fibrosis, advanced fibrosis and cirrhosis, the summary AUC were 0.86 (95% CI: 0.83–0.89), 0.94 (95% CI: 0.91–0.95) and 0.95 (95% CI: 0.93–0.97) for pSWE and the summary AUC was 0.85 (95% CI: 0.82–0.88), 0.92 (95% CI: 0.89–0.94) and 0.94 (95% CI: 0.93–0.97) for TE, respectively. The proportion of failure measurement was over tenfold as common with TE using an M probe compared to pSWE
Conclusion: pSWE and TE, providing precise non-invasive staging of liver fibrosis in NAFLD, are promising techniques, particularly for advanced fibrosis and cirrhosis.

研究目的：本研究旨在评估点剪切波弹性成像（Point shear wave Elastography, pSWE）与瞬时弹性成像（Transient Elastography, TE）用于非酒精性脂肪性肝病（Non-Alcoholic Fatty Liver Disease, NAFLD）患者肝纤维化分期的准确性。
研究设置：本研究检索了截至2017年12月20日PubMed、Embase、Web of Science及中国知网（China National Knowledge Infrastructure）数据库中收录的与NAFLD相关的文献记录。采用双变量混合效应模型合并分析TE与pSWE的灵敏度（Sensitivity, SE）、特异度（Specificity, SP）、阳性似然比（positive likelihood ratio, LR+）、阴性似然比（negative likelihood ratio, LR-）及综合受试者工作特征曲线下面积（Area Under Summary Receiver Operating Characteristic Curve, AUC）。此外开展敏感性分析以探究异质性来源。
研究对象：本研究纳入经肝活检前采用pSWE与TE完成肝硬度检测的NAFLD患者，纳入标准为：可通过报告的病例数、灵敏度及特异度计算得到2×2列联表；排除标准为：存在其他肝脏损伤病史者，包括慢性丙型肝炎、合并活动性乙型肝炎病毒感染、自身免疫性肝炎、可疑药物性肝损伤及酒精滥用者。
研究结果：最终纳入9项pSWE相关研究，共纳入982例患者；11项TE相关研究，共纳入1753例患者。针对显著肝纤维化、进展期肝纤维化及肝硬化的检测，pSWE的综合AUC分别为0.86（95%CI：0.83~0.89）、0.94（95%CI：0.91~0.95）及0.95（95%CI：0.93~0.97）；TE的综合AUC则分别为0.85（95%CI：0.82~0.88）、0.92（95%CI：0.89~0.94）及0.94（95%CI：0.93~0.97）。采用M探头时，TE的检测失败率约为pSWE的10倍以上。
研究结论：pSWE与TE均可对NAFLD患者的肝纤维化进行精准的无创分期，是颇具前景的无创检测技术，尤其在进展期肝纤维化及肝硬化的检测中优势显著。