Diagnostic Accuracy of Real-Time Tissue Elastography for the Staging of Liver Fibrosis: A Meta-Analysis

作者：Kobayashi Kunio; Nakao Haruhisa; Nishiyama Takeshi^*; Lin Yingsong; Kikuchi Shogo; Kobayashi Yuji; Yamamoto Takaya; Ishii Norimitsu; Ohashi Tomohiko; Satoh Ken; Nakade Yukiomi; Ito Kiyoaki; Yoneda Masashi

来源：European Radiology, 2015, 25(1): 230-238.

DOI：10.1007/s00330-014-3364-x

• Liver fibrosis
• Liver stiffness
• Real-time tissue elastography (RTE)
• Meta-analysis
• Summary Receiver Operating Characteristic Curve (SROC)

Objective To evaluate the overall accuracy of real-time tissue elastography (RTE) for the staging of liver fibrosis.
Methods We systematically reviewed 15 studies (1,626 subjects) in which sensitivity and specificity of RTE for liver fibrosis are available. For each cut-off stage of fibrosis, i.e., F >= 1, F >= 2, F >= 3, and F >= 4, summary sensitivity and specificity were estimated using a bivariate random-effects model. Publication bias was assessed using funnel plots and Egger's test.
Results Summary sensitivity and specificity were 0.79 and 0.76 for F >= 2, 0.82 and 0.81 for F >= 3, and 0.74 and 0.84 for F >= 4, respectively. Meta-regressions revealed scoring methods of RTE and liver diseases in the samples might not influence sensitivity and specificity of RTE. However, the estimated accuracy of RTE might be overestimated due to publication bias (p=0.004 for F >= 2, p< 0.001 for F >= 3, and p=0.002 for F >= 4).
Conclusions RTE is not highly accurate for any cut-off stage of fibrosis. Compared with findings of meta-analyses on Transient Elastography and Acoustic Radiation Force Impulse imaging, the overall accuracy of RTE seems to be nearly identical for the evaluation of significant liver fibrosis, but less accurate for the evaluation of cirrhosis.

• 出版日期2015-1