| Diagnostic accuracy of vibration-controlled transient elastography for staging liver fibrosis in autoimmune liver diseases: A systematic review and meta-analysis |
Jihyun An1, Young Eun Chon2, Gunho Kim3, Mi Na Kim4,5, Hee Yeon Kim6, Han Ah Lee7, Jung Hwan Yu8, Miyoung Choi9, Dae Won Jun10, Seung Up Kim4,5, Ji Won Han11
, Young-Joo Jin8
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1Department of Gastroenterology and Hepatology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
2Department of Internal Medicine, Institute of Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
3Hanyang University College of Medicine, Seoul, Korea
4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
5Yonsei Liver Center, Severance Hospital, Seoul, Korea
6Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
7Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
8Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
9Division of Health Technology Assessment Research, National EvidenceBased Healthcare Collaborating Agency (NECA), Seoul, Korea
10Department of Gastroenterology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
11Department of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea |
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Received: July 21, 2024 Revised: August 17, 2024 Accepted: August 20, 2024
*Jihyun An and Young Eun Chon contributed equally to this work. |
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| ABSTRACT |
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Background/Aims
The assessment of liver fibrosis is crucial for managing autoimmune liver diseases such as primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC). However, data on the efficacy of noninvasive tests for these diseases are limited. This meta-analysis evaluated the diagnostic accuracy of vibration-controlled transient elastography (VCTE) for staging fibrosis in patients with autoimmune liver disease.
Methods
Searches were conducted in PubMed, Embase, CINAHL, Web of Science, and Cochrane Library databases to assess the diagnostic accuracy of VCTE against histology as the reference standard in adult patients with autoimmune liver disease. The summary area under the curve (sAUC) and diagnostic odds ratio were calculated for significant fibrosis (SF), advanced fibrosis (AF), and cirrhosis, according to liver biopsy.
Results
Fourteen articles were included, comprising 559 PBC patients from six studies, 388 AIH patients from five studies, and 151 PSC patients from three studies. VCTE demonstrated good performance for fibrosis staging in PBC, AIH, and PSC. In PBC, sAUCs of VCTE were 0.87, 0.89, and 0.99 for staging SF, AF, and cirrhosis, respectively. In AIH, the sAUCs were 0.88, 0.88, and 0.92, respectively, while in PSC, they were 0.88, 0.95, and 0.92, respectively. The cutoff values for AF were 7.5–17.9 kPa in PBC, 8.18–12.1 kPa in AIH, and 9.6 kPa in PSC.
Conclusions
VCTE shows high diagnostic accuracy for staging liver fibrosis in patients with autoimmune liver diseases. This non-invasive method serves as a valuable tool for the evaluation and monitoring of fibrosis in these lifelong diseases. |
| KeyWords:
Liver fibrosis; Transient elastography; Autoimmune disease; Noninvasive test |
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