Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis.
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| Title: | Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis. |
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| Authors: | Song, Jinzhen1, Ma, Zida2, Huang, Jianbo3, Liu, Shiyu4, Luo, Yan1 wchluoyan@163.com, Lu, Qiang1 wsluqiang@126.com, Schwabl, Philipp5, Zykus, Romanas6, Kumar, Ashish7, Kitson, Matthew8 |
| Source: | European Radiology. Dec2018, Vol. 28 Issue 12, p5221-5230. 10p. 1 Diagram, 5 Charts, 2 Graphs. |
| Subjects: | Elastography, Portal hypertension, Liver diseases, Bivariate analysis, Three-dimensional imaging |
| Abstract: | Background: Transient elastography-based liver stiffness value (TE-LSV) has been investigated for assessing clinically significant portal hypertension (CSPH). The aetiology of CSPH is an important factor determining TE-LSV. There is insufficient evidence for selecting cut-off values.Aims: This study performed a meta-analysis to compare the three most widely used cut-off values (around 13.6 kPa, 18 kPa and 22kPa) of TE-LSV for the diagnosis of CSPH in patients with chronic viral liver disease.Methods: The PubMed, Ovid, Web of Science and Cochrane Library databases were searched. Diagnostic data for cut-off values around 13.6 kPa, 18 kPa and 22 kPa in each included study were extracted. The bivariate model was performed to estimate pooled sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-).Results: Eleven studies assessing 910 patients were included in this meta-analysis. Pooled sensitivities of cut-off values around 13.6 kPa, 18 kPa and 22 kPa were 0.96 (95% CI 0.93-0.97), 0.85 (0.81-0.89) and 0.74 (0.66-0.80), respectively; pooled specificities were 0.60 (0.47-0.75), 0.80 (0.71-0.87) and 0.94 (0.86-0.97), respectively. Pooled LR+ values were 2.4 (1.6-3.7), 4.4 (2.9-6.8) and 11.5 (5.5-23.5) for cut-off values around 13.6 kPa, 18 kPa and 22 kPa, respectively, for pooled LR- values of 0.07 (0.04-0.13), 0.17 (0.12-0.25) and 0.28 (0.22-0.36), respectively.Conclusion: Cut-off values around 13.6 kPa (high sensitivity) and 22 kPa (high specificity) could be used as screening and confirmation tools, respectively, in the diagnosis of CSPH. Overall, the cut-off value around 22 kPa showed the best performance.Key Points: Transient elastography-based liver stiffness could be used to diagnose portal hypertension.Comparison of certain cut-off values would provide more information for clinical decision-making.Cut-off around 13.6 kPa was able to exclude clinically significant portal hypertension (CSPH) effectively.Cut-off around 22 kPa was able to confirm CSPH effectively. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Items | – Name: Title Label: Title Group: Ti Data: Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Song%2C+Jinzhen%22">Song, Jinzhen</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Ma%2C+Zida%22">Ma, Zida</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Huang%2C+Jianbo%22">Huang, Jianbo</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Liu%2C+Shiyu%22">Liu, Shiyu</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Luo%2C+Yan%22">Luo, Yan</searchLink><relatesTo>1</relatesTo><i> wchluoyan@163.com</i><br /><searchLink fieldCode="AR" term="%22Lu%2C+Qiang%22">Lu, Qiang</searchLink><relatesTo>1</relatesTo><i> wsluqiang@126.com</i><br /><searchLink fieldCode="AR" term="%22Schwabl%2C+Philipp%22">Schwabl, Philipp</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Zykus%2C+Romanas%22">Zykus, Romanas</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Kumar%2C+Ashish%22">Kumar, Ashish</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Kitson%2C+Matthew%22">Kitson, Matthew</searchLink><relatesTo>8</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Dec2018, Vol. 28 Issue 12, p5221-5230. 10p. 1 Diagram, 5 Charts, 2 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Elastography%22">Elastography</searchLink><br /><searchLink fieldCode="DE" term="%22Portal+hypertension%22">Portal hypertension</searchLink><br /><searchLink fieldCode="DE" term="%22Liver+diseases%22">Liver diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Bivariate+analysis%22">Bivariate analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Three-dimensional+imaging%22">Three-dimensional imaging</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Transient elastography-based liver stiffness value (TE-LSV) has been investigated for assessing clinically significant portal hypertension (CSPH). The aetiology of CSPH is an important factor determining TE-LSV. There is insufficient evidence for selecting cut-off values.Aims: This study performed a meta-analysis to compare the three most widely used cut-off values (around 13.6 kPa, 18 kPa and 22kPa) of TE-LSV for the diagnosis of CSPH in patients with chronic viral liver disease.Methods: The PubMed, Ovid, Web of Science and Cochrane Library databases were searched. Diagnostic data for cut-off values around 13.6 kPa, 18 kPa and 22 kPa in each included study were extracted. The bivariate model was performed to estimate pooled sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-).Results: Eleven studies assessing 910 patients were included in this meta-analysis. Pooled sensitivities of cut-off values around 13.6 kPa, 18 kPa and 22 kPa were 0.96 (95% CI 0.93-0.97), 0.85 (0.81-0.89) and 0.74 (0.66-0.80), respectively; pooled specificities were 0.60 (0.47-0.75), 0.80 (0.71-0.87) and 0.94 (0.86-0.97), respectively. Pooled LR+ values were 2.4 (1.6-3.7), 4.4 (2.9-6.8) and 11.5 (5.5-23.5) for cut-off values around 13.6 kPa, 18 kPa and 22 kPa, respectively, for pooled LR- values of 0.07 (0.04-0.13), 0.17 (0.12-0.25) and 0.28 (0.22-0.36), respectively.Conclusion: Cut-off values around 13.6 kPa (high sensitivity) and 22 kPa (high specificity) could be used as screening and confirmation tools, respectively, in the diagnosis of CSPH. Overall, the cut-off value around 22 kPa showed the best performance.Key Points: Transient elastography-based liver stiffness could be used to diagnose portal hypertension.Comparison of certain cut-off values would provide more information for clinical decision-making.Cut-off around 13.6 kPa was able to exclude clinically significant portal hypertension (CSPH) effectively.Cut-off around 22 kPa was able to confirm CSPH effectively. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-018-5478-z Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 5221 Subjects: – SubjectFull: Elastography Type: general – SubjectFull: Portal hypertension Type: general – SubjectFull: Liver diseases Type: general – SubjectFull: Bivariate analysis Type: general – SubjectFull: Three-dimensional imaging Type: general Titles: – TitleFull: Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Song, Jinzhen – PersonEntity: Name: NameFull: Ma, Zida – PersonEntity: Name: NameFull: Huang, Jianbo – PersonEntity: Name: NameFull: Liu, Shiyu – PersonEntity: Name: NameFull: Luo, Yan – PersonEntity: Name: NameFull: Lu, Qiang – PersonEntity: Name: NameFull: Schwabl, Philipp – PersonEntity: Name: NameFull: Zykus, Romanas – PersonEntity: Name: NameFull: Kumar, Ashish – PersonEntity: Name: NameFull: Kitson, Matthew IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 12 Text: Dec2018 Type: published Y: 2018 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 28 – Type: issue Value: 12 Titles: – TitleFull: European Radiology Type: main |
| ResultId | 1 |
