Comparison of diagnostic accuracy of magnetic resonance elastography and Fibroscan for detecting liver fibrosis in chronic hepatitis B patients: A systematic review and meta-analysis

<div><p>Aim</p><p>This systematic review and meta-analysis was carried out to compare the diagnostic accuracy of Magnetic resonance elastography (MRE) and Fibroscan for detecting liver fibrosis in Chronic Hepatitis B (CHB) patients.</p><p>Methods</p><p>The PubMed, the Cochrane Library, and the Web of science databases were searched for studies that evaluated the diagnostic value of MRE and Fibroscan for liver fibrosis in CHB patients until March 1^st 2017. The quality of the included studies was assessed by the revised Quality Assessment for Studies of Diagnostic Accuracy tool (QUADAS-2). Meta-disc 4.1 was used to summary the area under receiver operating characteristics curve (AUROC), sensitivity, specificity, diagnostic odds ratios to assess the accuracy of staging liver fibrosis using MRE and Fibroscan.</p><p>Results</p><p>A total of nine MRE studies with 1470 patients and fifteen Fibroscan studies with 3641 patients were included in this systematic review. The summary AUROC values using MRE and Fibroscan for detecting significant fibrosis, advanced fibrosis and cirrhosis were 0.981 vs. 0.796(p<0.001), 0.972 vs. 0.893(p<0.001), and 0.972 vs. 0.905 (p<0.001). The pooled sensitivity and specificity using MRE for the diagnosis of significant fibrosis, advanced fibrosis and cirrhosis were 92.8% and 93.7%, 89.6% and 93.2%, 89.5% and 92.0%, respectively. The pooled sensitivity and specificity using Fibroscan for the diagnosis of significant fibrosis, advanced fibrosis and cirrhosis were 71.6% and 81.6%, 79.0% and 84.6%, 80.0% and 86.6%, respectively.</p><p>Conclusion</p><p>MRE is more accurate than Fibroscan in diagnosing liver fibrosis in CHB patients, especially in diagnosing significant fibrosis and advanced fibrosis.</p></div

Forest plots of the DOR of MRE and Fibroscan for staging significant fibrosis (F2), advanced fibrosis (F3) and cirrhosis (F4).

<p>The summary DOR of MRE is superior to Fibroscan for detecting significant fibrosis (F2), advanced fibrosis (F3) and cirrhosis (F4).</p

Meta-analysis results of MRE and Fibroscan for prediction of significant fibrosis, advanced fibrosis and cirrhosis.

<p>Meta-analysis results of MRE and Fibroscan for prediction of significant fibrosis, advanced fibrosis and cirrhosis.</p

Summary ROC curve of the diagnostic accuracy of MRE and Fibroscan for staging significant fibrosis (F2), advanced fibrosis (F3) and cirrhosis (F4).

<p>The summary AUROC values using MRE for detecting significant fibrosis(F2), advanced fibrosis(F3) and cirrhosis(F4) were all significantly higher than that using Fibroscan.</p

Deek’s funnel plot asymmetry test for publication bias.

<p>Considerable heterogeneity and publication bias was not observed in both MRE and Fibroscan studies for detecting liver fibrosis in CHB patients.</p

Heterogeneity of all the included studies.

<p>Heterogeneity of all the included studies.</p

Methodological quality of included studies according to the revised quality assessment for studies of diagnostic accuracy tool (QUADAS-2) (+: yes; -: no; unclear).

<p>Methodological quality of included studies according to the revised quality assessment for studies of diagnostic accuracy tool (QUADAS-2) (+: yes; -: no; unclear).</p

Table1_Metabolic dysfunction-associated steatotic liver disease increases hepatocellular carcinoma risk in chronic hepatitis B patients: a retrospective cohort study.DOCX

Background: The combined effect of hepatitis B virus infection and metabolic dysfunction-associated steatotic liver disease (MASLD) on hepatocellular carcinoma (HCC) risk remains unclear. The current study sought to elucidate the impact of MASLD on HCC progression in chronic hepatitis B (CHB) patients.Method: This retrospective cohort study included CHB patients who had undergone liver biopsy and abdominal imaging at the Guangdong Provincial Hospital of Chinese Medicine between 2013 and 2019. We investigated the correlation between MASLD and HCC risk, and inverse probability treatment weighting (IPTW) was used to adjust for patient characteristics.Results: A total of 1,613 patients were included, and 483 (29.9%) were diagnosed with MASLD. Over a median follow-up period of 5.02 years, 36 (2.2%) developed HCC, comprising 4.8% (23/483) of those with MASLD and 1.2% (13/1,130) of those without. Those with MASLD had a significantly higher cumulative incidence of HCC than those without (p Conclusion: The presence of MASLD is associated with a higher risk of HCC in patients with CHB. Notably, this higher risk is present in patients with MASLD, irrespective of the presence or absence of overweight or the number of CMRFs they have.</p