Elastography of shear wave speed imaging for the evaluation of liver fibrosis: A meta-analysis.

Aim A meta-analysis was carried out to assess the accuracies of shear wave speed imaging (SWSI) in predicting significant fibrosis (stages F2-4) and cirrhosis (stage F4). Methods A review was performed of relevant studies published until October 2015. A bivariate binomial model was used to combine the sensitivity, specificity, and the area under the summary receiver operating characteristic (AUC), and 95% confidence intervals were derived to indicate the diagnostic accuracy of imaging modalities. Results In total, 10 studies with 2182 patients were included in the analysis. The sensitivity, specificity, and AUC (with 95% confidence intervals) of SWSI were: 0.84 (0.81-0.87), 0.83 (0.77-0.88), and 0.88 (0.85-0.90) for significant fibrosis, respectively; and 0.80 (0.66-0.89), 0.93 (0.88-0.96), and 0.95 (0.92-0.96) for cirrhosis, respectively. When SWSI was compared with well-evaluated transient elastography, the AUCs for the prediction of significant fibrosis were 0.93 and 0.86, respectively. The AUCs for the prediction of cirrhosis were both 0.94. Conclusion Shear wave speed imaging is a trustworthy tool for staging hepatic fibrosis, with a high combination of sensitivity and specificity. Compared with transient elastography, SWSI showed better diagnostic performance for the prediction of significant fibrosis. [ABSTRACT FROM AUTHOR]