Diagnostic role of real-time shear wave elastography on staging of liver fibrosis

Background: Shear wave elastography (SWE) is one of newly-developed methods. Our meta-analysis was aimed to clarify whether SWE could be used as a diagnostic biomarker of liver fibrosis. Methods: We searched the potential articles in databases of PubMed, EMbase and Google Scholar. The discrimination of F0 from F1/4 (F≥1), F0/1 from F2/4 (F≥2), F0/2 from F3/4 (F≥3), and F0/3 from F4 (F≥4) were tested by SWE. Overall results of sensitivity and specificity along with 95% confidence intervals (95% CI) were used to evaluate the diagnostic accuracy. Summary receiver operating characteristic (SROC) curve was analyzed as well. The random-effects model or fixed-effects model was used according to the between-study heterogeneity. Results: 7 articles were included in the present meta-analysis. The tests for F≥2 based on 7 articles showed the sensitivity and specificity were 0.86 (0.82-0.89) and 0.76 (0.71-0.80), respectively. The area under curve (AUC) was 0.922. With respect to F≥3, overall sensitivity and specificity were 0.91 (0.85-0.95) and 0.84 (0.80-0.88). The corresponding AUC was 0.839. In terms of F≥4, high sensitivity and specificity were also obtained (sensitivity: 0.87; specificity: 0.87). AUC value of 0.934 also demonstrated the high accuracy of SWE. Conclusion: SWE appears to be a diagnostic biomarker with high accuracy for liver fibrosis.