RT Journal Article
T1 An individual patient data meta-analysis to determine cut-offs for and confounders of NAFLD-fibrosis staging with magnetic resonance elastography.
A1 Liang, Jia-xu
A1 Ampuero, Javier
A1 Niu, Hao
A1 Imajo, Kento
A1 Noureddin, Mazen
A1 Behari, Jaideep
A1 Lee, Dae Ho
A1 Ehman, Richard L.
A1 Rorsman, Fredrik
A1 Vessby, Johan
A1 Lacalle, Juan R.
A1 Mózes, Ferenc E.
A1 Pavlides, Michael
A1 Anstee, Quentin M.
A1 Harrison, Stephen A.
A1 Castell, Javier
A1 Loomba, Rohit
A1 Romero-Gomez, Manuel
K1 Hígado - Fibrosis
K1 Diagnóstico por imagen
K1 Imágenes por resonancia magnética
AB We conducted an individual patient data meta-analysis to establish stiffness cut-off values for magnetic resonance elastography (MRE) in staging liver fibrosis and to assess potential confounding factors. A systematic review of the literature identified studies reporting MRE data in patients with NAFLD. Data were obtained from the corresponding authors. The pooled diagnostic cut-off value for the various fibrosis stages was determined in a two-stage meta-analysis. Multilevel modelling methods were used to analyse potential confounding factors influencing the diagnostic accuracy of MRE in staging liver fibrosis. 8 independent cohorts comprising 798 patients were included in the meta-analysis. The area under the ROC curve (AUROC) for MRE in detecting significant fibrosis was 0.92 (sensitivity, 79%; specificity, 89%). For advanced fibrosis, the AUROC was 0.92 (sensitivity, 87%; specificity, 88%). For cirrhosis, the AUROC was 0.94 (sensitivity, 88%, specificity, 89%). Cut-offs were defined to explore concordance between MRE and histopathology: ≥F2, 3.14 kPa (pretest probability, 39.4%); ≥F3, 3.53 kPa (pretest probability, 24.1%); and F4, 4.45 kPa (pretest probability, 8.7%). In generalized linear mixed model analysis, histological steatohepatitis with higher inflammatory activity (odds ratio 2.448, 95% CI 1.180–5.079, p <0.05) and high gamma-glutamyl transferase (GGT) concentration (>120U/L) (odds ratio 3.388, 95% CI 1.577–7.278, p <0.01] were significantly associated with elevated liver stiffness, and thus affecting accuracy in staging early fibrosis (F0–F1). Steatosis, as measured by magnetic resonance imaging proton density fat fraction, and body mass index (BMI) were not confounders. MRE has excellent diagnostic performance for significant, advanced fibrosis and cirrhosis in patients with NAFLD. Elevated inflammatory activity and GGT level may lead to overestimation of early liver fibrosis, but anthropometric measures such as BMI or the degree of steatosis do not.
PB Elsevier
YR 2023
FD 2023
LK https://hdl.handle.net/10630/37986
UL https://hdl.handle.net/10630/37986
LA eng
NO Liang JX, Ampuero J, Niu H, Imajo K, Noureddin M, Behari J, Lee DH, Ehman RL, Rorsman F, Vessby J, Lacalle JR, Mózes FE, Pavlides M, Anstee QM, Harrison SA, Castell J, Loomba R, Romero-Gómez M; LITMUS Consortium Investigators. An individual patient data meta-analysis to determine cut-offs for and confounders of NAFLD-fibrosis staging with magnetic resonance elastography. J Hepatol. 2023;79(3):592-604
NO We would like to thank LITMUS (Liver Investigation: Testing Marker Utility in Steatohepatitis) project for supporting this research. The LITMUS study is funded by the Innovative Medicines Initiative 2 (IMI2) Joint Undertaking under grant agreement 777377. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and the EuropeanFederation of Pharmaceutical Industries and Associations (EFPIA; efpia.edu). RL receives funding support from NCATS (5UL1TR001442), NIDDK (U01DK061734, U01DK130190, R01DK106419, R01DK121378, R01DK124318, and P30DK120515), NHLBI (P01HL147835), and NIAAA (U01AA029019). QMA is a coordinator of the LITMUS consortium and a Newcastle NIHR Biomedical Research Centre investigator. MP acknowledges support from the Oxford NIHR Biomedical Research Centre. RLE acknowledges support from the National Institutes of Health (grant R37 EB001981). DHL received a grant from KHIDI (KoreaHealth Industry Development Institute) (HI14C1135), funded by the Ministry of Health and Welfare, Korea. JB acknowledges funding support from NCATS (4UH3TR003289), NCI 1R01CA255809, and NIAAA (5U01AA026978).
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 20 ene 2026