Jae-Yeon Hwang1, Hee Mang Yoon2, Jeong Rye Kim2, Jin Seong Lee2, Ah Young Jung2, Kyung Mo Kim3, Young Ah Cho2. 1. 1 Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University, Yangsan Hospital, Gyeongsangnam-do, Republic of Korea. 2. 2 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea. 3. 3 Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea.
Abstract
OBJECTIVE: We aimed to assess the diagnostic performance of transient elastography for evaluating liver fibrosis in children and adolescents. MATERIALS AND METHODS: A computerized search of Medline and Embase up to December 31, 2017, was performed to identify studies. Studies evaluating the diagnostic performance of transient elastography for the severity of liver fibrosis in children and adolescents were selected. Pooled sensitivity and specificity were calculated using hierarchic logistic regression modeling. Multiple subgroup analysis was performed. RESULTS: In this meta-analysis that included 11 original articles involving 723 patients, transient elastography showed a summary sensitivity of 95% (95% CI, 74-99%) and a specificity of 90% (95% CI, 81-95%) for the diagnosis of significant liver fibrosis (stage ≥ F2) in children. The hierarchic summary ROC AUC was 0.96 (95% CI, 0.94-0.98). Multiple subgroup analysis for the diagnosis of significant hepatic fibrosis showed clinically acceptable ranges of sensitivity and specificity across all subgroups. In additional subgroup analysis, the diagnostic accuracies of transient elastography according to the Metavir system were also within a clinically acceptable range, measured up to a sensitivity of 86% and specificity of 86% for diagnosing Metavir stage F4 fibrosis. CONCLUSION: Transient elastography showed highly accurate diagnostic performance for the diagnosis of liver fibrosis in children.
OBJECTIVE: We aimed to assess the diagnostic performance of transient elastography for evaluating liver fibrosis in children and adolescents. MATERIALS AND METHODS: A computerized search of Medline and Embase up to December 31, 2017, was performed to identify studies. Studies evaluating the diagnostic performance of transient elastography for the severity of liver fibrosis in children and adolescents were selected. Pooled sensitivity and specificity were calculated using hierarchic logistic regression modeling. Multiple subgroup analysis was performed. RESULTS: In this meta-analysis that included 11 original articles involving 723 patients, transient elastography showed a summary sensitivity of 95% (95% CI, 74-99%) and a specificity of 90% (95% CI, 81-95%) for the diagnosis of significant liver fibrosis (stage ≥ F2) in children. The hierarchic summary ROC AUC was 0.96 (95% CI, 0.94-0.98). Multiple subgroup analysis for the diagnosis of significant hepatic fibrosis showed clinically acceptable ranges of sensitivity and specificity across all subgroups. In additional subgroup analysis, the diagnostic accuracies of transient elastography according to the Metavir system were also within a clinically acceptable range, measured up to a sensitivity of 86% and specificity of 86% for diagnosing Metavir stage F4 fibrosis. CONCLUSION: Transient elastography showed highly accurate diagnostic performance for the diagnosis of liver fibrosis in children.
Authors: Dorota Wicher; Irena Jankowska; Patryk Lipiński; Paulina Szymańska-Rożek; Jakub Kmiotek; Wojciech Jańczyk; Jacek Rubik; Krystyna Chrzanowska; Piotr Socha Journal: Front Pediatr Date: 2019-01-11 Impact factor: 3.418