Acoustic Radiation Force Impulse Elastography for the Non-Invasive Evaluation of Hepatic Fibrosis in Non-Alcoholic Fatty Liver Disease Patients: A Systematic Review & Meta-Analysis

<div><p>Background</p><p>In order to better monitor non-alcoholic fatty liver disease (NAFLD) patients at higher risk for HCC, there is a need for non-invasive diagnostic approaches to screen for the presence of advanced fibrosis in these patients. The aim of this systematic review and meta-analysis will be to evaluate the diagnostic efficacy of ARFI elastography in detecting hepatic fibrosis in NAFLD patients.</p><p>Methods</p><p>Relevant studies were identified from systematic searches of several major electronic databases (PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials). The primary outcomes were the summary sensitivity, summary specificity, the diagnostic odds ratio, and the summary receiver operating characteristic curve (SROC) of ARFI elastography in detecting significant fibrosis (defined as 4>F≥2) in NAFLD patients. Study quality was assessed using the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Review (QUADAS-2).</p><p>Results</p><p>The summary sensitivity and specificity of ARFI in detecting significant fibrosis were 80.2% (95% confidence interval (CI): 0.758–0.842; <i>p</i> = 0.0000) and 85.2% (95% CI: 0.808–0.890), <i>p</i> = 0.1617), respectively. The pooled diagnostic odds ratio of ARFI in detecting significant fibrosis was 30.13 (95% CI: 12.08–75; chi-squared = 14.59, <i>p</i> = 0.0237). The area under the SROC curve (AUC) was 0.898 (standard error (SE): 0.031) with a Q* index of 0.830 (SE: 0.033).</p><p>Conclusions</p><p>ARFI elastography appears to be modestly accurate in detecting significant fibrosis in NAFLD patients. Future studies in this field should provide head-to-head comparisons of ARFI elastography versus other elastographic imaging modalities in NAFLD patients.</p></div

Summary Receiving Operating Characteristic Curve (SROC) Plot.

<p>The SROC and its 95% confidence interval (CI) boundaries are represented by the three blue lines. Each of the included studies is represented by a red circle with the weight of each study depicted by the size of its respective circle. The area under the curve (AUC) was calculated by numerical integration of the SROC.</p

Characteristics of Included Studies.

<p>Abbreviations: Dx, diagnosis; Tech fail, technical failures; R, Spearman’s correlation coefficient between ARFI and fibrosis; Sn, sensitivity; Sp, specificity; AUC, area under the receiver operating characteristic (ROC) curve; NASH, xxxx; NAFLD, xxxxx; NR, not reported</p><p>*Only the subpopulation of NASH patients were included.</p><p>Characteristics of Included Studies.</p

Forest Plots of Sensitivity & Specificity.

<p>The red circles and the horizontal blue lines represent the point estimates and 95% confidence intervals (CIs) of the included studies, respectively. The weight of each study is depicted by the size of its respective circle. The center of the red diamond represents the pooled estimate, and the red dotted lines represent the 95% CI of the pooled estimate.</p

The time-dependent receiver operating characteristics analysis of the plasma fibrinogen level to predict metastasis and death in patients with operable breast cancer.

<p>The time-dependent receiver operating characteristics analysis of the plasma fibrinogen level to predict metastasis and death in patients with operable breast cancer.</p

Box plots indicating the distribution of the pretreatment plasma fibrinogen levels and the following clinicopathological parameters: age (A), menopause (B), tumor stage (C), tumor size (D), lymphatic metastasis (E), and lymph node involvement (F).

<p>The horizontal bar in the box indicates the median value, the box indicates the 1st (25%) and 3rd (75%) quartile, the whiskers indicate 5–95%, the open circles indicate the outlier</p

Univariate and multivariate survival analysis in patients with operable breast cancer.

<p>Univariate and multivariate survival analysis in patients with operable breast cancer.</p

Baseline characteristics of the patients.

<p>Baseline characteristics of the patients.</p

A, B Kaplan-Meier curves for DFS and OS according to plasma fibrinogen levels (curves were separated by the cutoff value).

<p>A, B Kaplan-Meier curves for DFS and OS according to plasma fibrinogen levels (curves were separated by the cutoff value).</p

Greatly Improved the Tunable Amplitude of Ferromagnetism Based on Interface Effect of Flexible Pt/YIG Heterojunctions

Flexible quantum spin electronic devices based on ferromagnetic insulators have attracted wide attention due to their outstanding advantages of low-power dissipation and noncontact sensing. However, ferromagnetic insulators, such as monocrystalline yttrium iron garnet (Y3Fe5O12, YIG), hve weak stress effects with a small magnetostrictive coefficient (λ110, 10 ppm), making it difficult to achieve a large magnetic tunable amplitude. In this paper, large-scale (with a diameter of 40 mm), flexible Pt/YIG heterojunctions were obtained by double-cavity magnetron sputtering technology, indicating typical soft magnetism and good bending fatigue characteristics. Here, the 3 nm thickness of the Pt layer triggers an obvious magnetic proximity effect, in which the in-plane ferromagnetic resonance field is decreased by 70 Oe compared to flexible Cu/YIG heterojunctions. Meanwhile, it shows a wide tunable amplitude of 110 Oe under the flexible bending stresses, which is induced by the sensitive interface effect of Pt (3 nm)/YIG heterojunctions. The saturation magnetization of Pt/YIG heterojunctions is negatively correlated with Pt thickness rather than the relative stability of Cu/YIG heterojunctions, depending on the magnetic proximity effect. It brings greater application possibilities for flexible stress-sensitive magnetic oxides in spin logic electronic devices