Performance of Transient Elastography for the Staging of Liver Fibrosis in Patients with Chronic Hepatitis B: A Meta-Analysis

Young Eun Chon, Eun Hee Choi, Ki Jun Song, Jun Yong Park, Do Young Kim, Kwang Hyub Han, Chae Yoon Chon, Sang Hoon Ahn, Seung Up Kim

Research output: Contribution to journalArticle

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Abstract

Background: Transient elastography (TE), a non-invasive tool that measures liver stiffness, has been evaluated in meta-analyses for effectiveness in assessing liver fibrosis in European populations with chronic hepatitis C (CHC). However, these data cannot be extrapolated to populations in Asian countries, where chronic hepatitis B (CHB) is more prevalent. In this study, we performed a meta-analysis to assess the overall performance of TE for assessing liver fibrosis in patients with CHB. Methods: Studies from the literature and international conference abstracts which enrolled only patients with CHB or performed a subgroup analysis of such patients were enrolled. Combined effects were calculated using area under the receiver operating characteristic curves (AUROC) and diagnostic accuracy values of each study. Result: A total of 18 studies comprising 2,772 patients were analyzed. The mean AUROCs for the diagnosis of significant fibrosis (F2), severe fibrosis (F3), and cirrhosis (F4) were 0.859 (95% confidence interval [CI], 0.857-0.860), 0.887 (95% CI, 0.886-0.887), and 0.929 (95% CI, 0.928-0.929), respectively. The estimated cutoff for F2 was 7.9 (range, 6.1-11.8) kPa, with a sensitivity of 74.3% and specificity of 78.3%. For F3, the cutoff value was determined to be 8.8 (range, 8.1-9.7) kPa, with a sensitivity of 74.0% and specificity of 63.8%. The cutoff value for F4 was 11.7 (range, 7.3-17.5) kPa, with a sensitivity of 84.6% and specificity of 81.5%. Conclusion: TE can be performed with good diagnostic accuracy for quantifying liver fibrosis in patients with CHB.

Original languageEnglish
Article numbere44930
JournalPloS one
Volume7
Issue number9
DOIs
Publication statusPublished - 2012 Sep 25

Fingerprint

chronic hepatitis B
Elasticity Imaging Techniques
liver cirrhosis
Chronic Hepatitis B
meta-analysis
Liver Cirrhosis
Liver
Meta-Analysis
confidence interval
Fibrosis
Confidence Intervals
fibrosis
Sensitivity and Specificity
chronic hepatitis C
Chronic Hepatitis C
ROC Curve
Stiffness
Population
liver

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

@article{5963ef68470248bea78f9c47b0514852,
title = "Performance of Transient Elastography for the Staging of Liver Fibrosis in Patients with Chronic Hepatitis B: A Meta-Analysis",
abstract = "Background: Transient elastography (TE), a non-invasive tool that measures liver stiffness, has been evaluated in meta-analyses for effectiveness in assessing liver fibrosis in European populations with chronic hepatitis C (CHC). However, these data cannot be extrapolated to populations in Asian countries, where chronic hepatitis B (CHB) is more prevalent. In this study, we performed a meta-analysis to assess the overall performance of TE for assessing liver fibrosis in patients with CHB. Methods: Studies from the literature and international conference abstracts which enrolled only patients with CHB or performed a subgroup analysis of such patients were enrolled. Combined effects were calculated using area under the receiver operating characteristic curves (AUROC) and diagnostic accuracy values of each study. Result: A total of 18 studies comprising 2,772 patients were analyzed. The mean AUROCs for the diagnosis of significant fibrosis (F2), severe fibrosis (F3), and cirrhosis (F4) were 0.859 (95{\%} confidence interval [CI], 0.857-0.860), 0.887 (95{\%} CI, 0.886-0.887), and 0.929 (95{\%} CI, 0.928-0.929), respectively. The estimated cutoff for F2 was 7.9 (range, 6.1-11.8) kPa, with a sensitivity of 74.3{\%} and specificity of 78.3{\%}. For F3, the cutoff value was determined to be 8.8 (range, 8.1-9.7) kPa, with a sensitivity of 74.0{\%} and specificity of 63.8{\%}. The cutoff value for F4 was 11.7 (range, 7.3-17.5) kPa, with a sensitivity of 84.6{\%} and specificity of 81.5{\%}. Conclusion: TE can be performed with good diagnostic accuracy for quantifying liver fibrosis in patients with CHB.",
author = "Chon, {Young Eun} and Choi, {Eun Hee} and Song, {Ki Jun} and Park, {Jun Yong} and Kim, {Do Young} and Han, {Kwang Hyub} and Chon, {Chae Yoon} and Ahn, {Sang Hoon} and Kim, {Seung Up}",
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Performance of Transient Elastography for the Staging of Liver Fibrosis in Patients with Chronic Hepatitis B : A Meta-Analysis. / Chon, Young Eun; Choi, Eun Hee; Song, Ki Jun; Park, Jun Yong; Kim, Do Young; Han, Kwang Hyub; Chon, Chae Yoon; Ahn, Sang Hoon; Kim, Seung Up.

In: PloS one, Vol. 7, No. 9, e44930, 25.09.2012.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Performance of Transient Elastography for the Staging of Liver Fibrosis in Patients with Chronic Hepatitis B

T2 - A Meta-Analysis

AU - Chon, Young Eun

AU - Choi, Eun Hee

AU - Song, Ki Jun

AU - Park, Jun Yong

AU - Kim, Do Young

AU - Han, Kwang Hyub

AU - Chon, Chae Yoon

AU - Ahn, Sang Hoon

AU - Kim, Seung Up

PY - 2012/9/25

Y1 - 2012/9/25

N2 - Background: Transient elastography (TE), a non-invasive tool that measures liver stiffness, has been evaluated in meta-analyses for effectiveness in assessing liver fibrosis in European populations with chronic hepatitis C (CHC). However, these data cannot be extrapolated to populations in Asian countries, where chronic hepatitis B (CHB) is more prevalent. In this study, we performed a meta-analysis to assess the overall performance of TE for assessing liver fibrosis in patients with CHB. Methods: Studies from the literature and international conference abstracts which enrolled only patients with CHB or performed a subgroup analysis of such patients were enrolled. Combined effects were calculated using area under the receiver operating characteristic curves (AUROC) and diagnostic accuracy values of each study. Result: A total of 18 studies comprising 2,772 patients were analyzed. The mean AUROCs for the diagnosis of significant fibrosis (F2), severe fibrosis (F3), and cirrhosis (F4) were 0.859 (95% confidence interval [CI], 0.857-0.860), 0.887 (95% CI, 0.886-0.887), and 0.929 (95% CI, 0.928-0.929), respectively. The estimated cutoff for F2 was 7.9 (range, 6.1-11.8) kPa, with a sensitivity of 74.3% and specificity of 78.3%. For F3, the cutoff value was determined to be 8.8 (range, 8.1-9.7) kPa, with a sensitivity of 74.0% and specificity of 63.8%. The cutoff value for F4 was 11.7 (range, 7.3-17.5) kPa, with a sensitivity of 84.6% and specificity of 81.5%. Conclusion: TE can be performed with good diagnostic accuracy for quantifying liver fibrosis in patients with CHB.

AB - Background: Transient elastography (TE), a non-invasive tool that measures liver stiffness, has been evaluated in meta-analyses for effectiveness in assessing liver fibrosis in European populations with chronic hepatitis C (CHC). However, these data cannot be extrapolated to populations in Asian countries, where chronic hepatitis B (CHB) is more prevalent. In this study, we performed a meta-analysis to assess the overall performance of TE for assessing liver fibrosis in patients with CHB. Methods: Studies from the literature and international conference abstracts which enrolled only patients with CHB or performed a subgroup analysis of such patients were enrolled. Combined effects were calculated using area under the receiver operating characteristic curves (AUROC) and diagnostic accuracy values of each study. Result: A total of 18 studies comprising 2,772 patients were analyzed. The mean AUROCs for the diagnosis of significant fibrosis (F2), severe fibrosis (F3), and cirrhosis (F4) were 0.859 (95% confidence interval [CI], 0.857-0.860), 0.887 (95% CI, 0.886-0.887), and 0.929 (95% CI, 0.928-0.929), respectively. The estimated cutoff for F2 was 7.9 (range, 6.1-11.8) kPa, with a sensitivity of 74.3% and specificity of 78.3%. For F3, the cutoff value was determined to be 8.8 (range, 8.1-9.7) kPa, with a sensitivity of 74.0% and specificity of 63.8%. The cutoff value for F4 was 11.7 (range, 7.3-17.5) kPa, with a sensitivity of 84.6% and specificity of 81.5%. Conclusion: TE can be performed with good diagnostic accuracy for quantifying liver fibrosis in patients with CHB.

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