Imaging-based noninvasive liver disease assessment for staging liver fibrosis in chronic liver disease: A systematic review supporting the AASLD Practice Guideline

作者：Andrés Duarte‐Rojo, Bachir A. Taouli, Daniel H. Leung, Deborah Brown Levine, Tarek Nayfeh, Bashar Hasan, Yahya Alsawaf, Samer Mohir Saadi, Abdul M. Majzoub, Apostolos Manolopoulos, Samir Haffar, Ayca Dundar, Mohammad Hassan Murad, Don C. Rockey, Mouaz Alsawas, Richard K. Sterling · 发表于：Hepatology · 年份：2024 · DOI：10.1097/hep.0000000000000852 · 被引用次数：64 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Ultrasound Imaging and Elastography

BACKGROUND AND AIMS: Transient elastography (TE), shear wave elastography, and/or magnetic resonance elastography (MRE), each providing liver stiffness measurement (LSM), are the most studied imaging-based noninvasive liver disease assessment (NILDA) techniques. To support the American Association for the Study of Liver Diseases guidelines on NILDA, we summarized the evidence on the accuracy of these LSM methods to stage liver fibrosis (F). APPROACH AND RESULTS: A comprehensive search for studies assessing LSM by TE, shear wave elastography, or MRE for the identification of significant fibrosis (F2-4), advanced fibrosis (F3-4), or cirrhosis (F4), using histopathology as the standard of reference by liver disease etiology in adults or children from inception to April 2022 was performed. We excluded studies with <50 patients with a single disease entity and mixed liver disease etiologies (with the exception of HCV/HIV coinfection). Out of 9447 studies, 240 with 61,193 patients were included in this systematic review. In adults, sensitivities for the identification of F2-4 ranged from 51% to 95%, for F3-4 from 70% to 100%, and for F4 from 60% to 100% across all techniques/diseases, whereas specificities ranged from 36% to 100%, 74% to 100%, and 67% to 99%, respectively. The largest body of evidence available was for TE; MRE appeared to be the most accurate method. Imaging-based NILDA outperformed blood-based NILDA in most comparisons, particularly for the identification of F3-4/...