Diagnostic Accuracy of 2D-Shear Wave Elastography for Liver Fibrosis Severity: A Meta-Analysis

PURPOSE To evaluate the accuracy of shear wave elastography (SWE) in the quantitative diagnosis of liver fibrosis severity. METHODS The published literatures were systematically retrieved from PubMed, Embase, Web of science and Scopus up to May 13th, 2016. Included studies reported the pooled sensitivity, specificity, positive and negative predictive values, as well as the diagnostic odds ratio of SWE in populations with liver fibrosis. A bivariate mixed-effects regression model was used, which was estimated by the I2 statistics. The quality of articles was evaluated by quality assessment of diagnostic accuracy studies (QUADAS). RESULTS Thirteen articles including 2303 patients were qualified for the study. The pooled sensitivity and specificity of SWE for the diagnosis of liver fibrosis are as follows: ≥F1 0.76 (p<0.001, 95% CI, 0.71-0.81, I2 = 75.33%), 0.92 (p<0.001, 95% CI, 0.80-0.97, I2 = 79.36%); ≥F2 0.84 (p = 0.35, 95% CI, 0.81-0.86, I2 = 9.55%), 0.83 (p<0.001, 95% CI, 0.77-0.88, I2 = 86.56%); ≥F3 0.89 (p = 0.56, 95% CI, 0.86-0.92, I2 = 0%), 0.86 (p<0.001, 95% CI, 0.82-0.90, I2 = 75.73%); F4 0.89 (p = 0.24, 95% CI, 0.84-0.92, I2 = 20.56%), 0.88 (p<0.001, 95% CI, 0.84-0.92, I2 = 82.75%), respectively. Sensitivity analysis showed no significant changes if any one of the studies was excluded. Publication bias was not detected in this meta-analysis. CONCLUSIONS Our study suggests that SWE is a helpful method to appraise liver fibrosis severity. Future studies that validate these findings would be appropriate.