Liver stiffness assessed by elastography for the evaluation of hepatocellular carcinoma risk in patients with fibrosis: a systematic review and meta-analysis.

Q3 Medicine
Radiologia Brasileira Pub Date : 2025-06-02 eCollection Date: 2025-01-01 DOI:10.1590/0100-3984.2024.0108
Marielle Malucelli Mallmann, Fernando Linhares Pereira, Maria Cristina Chammas, Márcio Luís Duarte, Ana Maria Andrade, Emilton Lima Júnior, Odery Ramos Júnior
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Abstract

This study aimed to systematically review the highest-quality evidence regarding the cutoff value in kPa for the diagnostic accuracy of ultrasound-based liver elastography in comparison with reference standards, including magnetic resonance imaging (MRI), computed tomography, and liver biopsy. In addition, we assessed the presence of hepatocellular carcinoma (HCC) and its associated implications in clinical and diagnostic contexts. We conducted a search using Medical Subject Headings across PubMed, Embase, Cochrane Library, Web of Science, Scopus, and Lilacs for articles published up to June 6, 2024. Of 1,131 studies identified, 33 were eligible and 8 met the quality criteria, as evaluated with the "RTI Item Bank" and "QUADAS-2" tools, following the PICO strategy. The mean elasticity of the liver parenchyma among patients with confirmed HCC was 18.77 kPa (95% CI: 16.28-21.27), making ultrasound liver elastography useful as a predictor of the diagnosis by gold-standard methods such as MRI. Ultrasound elastography is a low-cost, accessible, and noninvasive diagnostic tool capable of estimating liver elasticity in patients with HCC. However, due to the heterogeneity of the articles included in this review, further prospective studies are needed in order to confirm and standardize a cutoff stiffness value for early HCC screening, which could improve patient outcomes, particularly in resource-limited settings.

肝硬度通过弹性成像评估肝纤维化患者的肝细胞癌风险:系统回顾和荟萃分析。
本研究旨在与参考标准(包括磁共振成像(MRI)、计算机断层扫描和肝活检)进行比较,系统地回顾有关kPa截断值对超声肝弹性成像诊断准确性的最高质量证据。此外,我们评估了肝细胞癌(HCC)的存在及其在临床和诊断方面的相关意义。我们使用PubMed、Embase、Cochrane图书馆、Web of Science、Scopus和Lilacs上的医学主题词进行了检索,检索截止到2024年6月6日发表的文章。在确定的1131项研究中,33项符合条件,8项符合质量标准,根据PICO策略,使用“RTI Item Bank”和“QUADAS-2”工具进行评估。确诊HCC患者肝实质的平均弹性为18.77 kPa (95% CI: 16.28-21.27),这使得超声肝弹性成像可作为金标准方法(如MRI)诊断的预测指标。超声弹性成像是一种低成本、易获得、无创的诊断工具,能够评估HCC患者的肝脏弹性。然而,由于本综述中纳入的文章的异质性,需要进一步的前瞻性研究来确认和标准化早期HCC筛查的临界值,这可以改善患者的预后,特别是在资源有限的情况下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Radiologia Brasileira
Radiologia Brasileira Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
2.60
自引率
0.00%
发文量
75
审稿时长
28 weeks
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