Diagnostic accuracy of two-dimensional shear wave elastography and point shear wave elastography in identifying different stages of liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease: A meta-analysis

TL;DR

This study compares the accuracy of two ultrasound techniques in detecting liver fibrosis stages in patients with a liver condition linked to metabolic issues.

Contribution

The study provides a meta-analysis comparing the diagnostic accuracy of 2-D SWE and pSWE for liver fibrosis stages in MASLD patients.

Findings

Both 2-D SWE and pSWE showed high accuracy in identifying liver fibrosis stages in MASLD patients.

pSWE had higher specificity than 2-D SWE for advanced fibrosis and cirrhosis stages.

The pooled sensitivity and specificity values indicate strong diagnostic performance for both techniques.

Abstract

To assess the diagnostic accuracy of two-dimensional shear wave elastography (2-D SWE) and point shear wave elastography (pSWE) in detecting liver fibrosis stages in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), a comprehensive search was conducted across four databases up to February 9, 2024. A bivariate random-effects model was used to analyze the diagnostic accuracy of the methods. After screening, 13 studies involving pSWE included 1527 patients, while nine studies involving 2-D SWE included 1088 patients. The areas under the summary receiver operating characteristic (SROC) curves for diagnosing significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3), and cirrhosis (F ═ 4) using pSWE and 2-D SWE were as follows: 0.84 (95% CI 0.80–0.87), 0.91 (95% CI 0.88–0.93), and 0.94 (95% CI 0.91–0.95) for pSWE; 0.83 (95% CI 0.79–0.86) 0.85 (95% CI 0.82–0.88), and 0.89 (95% CI 0.86–0.91) for 2-D SWE, respectively. The pooled sensitivity for pSWE and 2-D SWE for stages F ≥ 2, F ≥ 3, and F ═ 4 were 0.71 (95% CI 0.63–0.78), 0.81 (95% CI 0.72–0.88), and 0.81 (95% CI 0.63–0.91) for pSWE, and 0.77 (95% CI 0.68–0.84), 0.80 (95% CI 0.72–0.87), and 0.92 (95% CI 0.75–0.98) for 2-D SWE, respectively. The pooled specificity of pSWE and 2-D SWE for these stages were 0.83 (95% CI 0.76–0.88), 0.87 (95% Cl: 0.81–0.92), and 0.91 (95% CI 0.86–0.94) for pSWE, and 0.76 (95% CI 0.66–0.84), 0.76 (95% CI 0.69–0.82), and 0.83 (95% CI 0.78–0.85) for 2-D SWE, respectively. In conclusion, both 2-D SWE and pSWE demonstrated high diagnostic performance in identifying various stages of liver fibrosis in MASLD patients.

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