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Diagnostic accuracy of hepatic proton density fat fraction measured by magnetic resonance imaging for the evaluation of liver steatosis with histology as reference standard: a meta-analysis

  • Yali Qu
  • Mou Li
  • Gavin Hamilton
  • Yingzhen N. Zhang
  • Bin SongEmail author
Magnetic Resonance
  • 41 Downloads

Abstract

Objectives

The aim of this meta-analysis was to evaluate the diagnostic accuracy of hepatic magnetic resonance imaging-proton density fat fraction (MRI-PDFF) for the assessment of liver steatosis (LS) with histology as reference standard.

Methods

A systematic literature search was performed to identify pertinent studies. Quality analyses were conducted by Quality Assessment of Diagnostic Accuracy Studies-2. Diagnostic data were extracted and inconsistency index was calculated for LS≥G1, LS≥G2, and LS=G3, respectively. The area under summary receiver operating characteristic curve (AUC) served as the indicator of diagnostic accuracy. The pooled sensitivity and specificity were calculated if threshold effect was absent.

Results

Thirteen studies containing 1100 subjects were included. There was significant threshold effect for LS≥G1. The AUCs for LS≥G1, LS≥G2, and LS=G3 were 0.98 (95% confidence interval (CI) 0.76, 1.00), 0.91 (95% CI 0.89, 0.94), and 0.92 (95% CI 0.89, 0.94), respectively. The pooled sensitivities for LS≥G2 and LS=G3 were 0.83 (95% CI 0.75, 0.88) and 0.79 (95% CI 0.63, 0.90), respectively; the pooled specificities for LS≥G2 and LS=G3 were 0.89 (95% CI 0.84, 0.92) and 0.89 (95% CI 0.84, 0.92), respectively.

Conclusions

MRI-PDFF has high diagnostic accuracy at detecting and grading LS with histology as reference standard, suggesting that MRI-PDFF is able to provide an accurate quantification of LS in clinical trials and patient care.

Key Point

MRI-PDFF is able to provide an accurate quantification of LS in clinical trials and patient care.

Keywords

Fatty liver Magnetic resonance imaging Area under curve Meta-analysis 

Abbreviations

AUC

Area under summary receiver operating characteristic curve

CI

Confidence interval

CSE-MRI

Chemical shift–encoded magnetic resonance imaging

FN

False negative

FP

False positive

LS

Liver steatosis

MeSH

Medical Subject Headings

MRS

Magnetic resonance spectroscopy

NAFLD

Nonalcoholic fatty liver disease

NASH

Nonalcoholic steatohepatitis

PDFF

Proton density fat fraction

SEN

Sensitivity

SPE

Specificity

SROC

Summary receiver operating characteristic

TN

True negative

TP

True positive

Notes

Funding

This study has received funding by the National Natural Science Foundation of China, No. 81471658.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Bin Song.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because this study is based on the published studies to perform the meta-analysis.

Ethical approval

Institutional Review Board approval was not required because this study is based on the published studies to perform data analysis.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

Supplementary material

330_2019_6071_MOESM1_ESM.docx (45 kb)
ESM 1 (DOCX 44 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
  2. 2.Liver Imaging Group, Department of RadiologyUniversity of California at San DiegoLa JollaUSA

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