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Diagnostic value of MRI-PDFF for hepatic steatosis in patients with non-alcoholic fatty liver disease: a meta-analysis

  • Magnetic Resonance
  • Published:
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Abstract

Objective

To systematically review studies about the diagnostic accuracy of magnetic resonance imaging proton density fat fraction (MRI-PDFF) in the classification of hepatic steatosis grade in patients with non-alcoholic fatty liver disease (NAFLD).

Methods

Areas under the summary receiver operating characteristic curves (AUROC), sensitivity, specificity, overall diagnostic odds ratio (DOR), diagnostic score, positive likelihood ratio (+LR), and negative likelihood ratio (−LR) for MRI-PDFF in classification of steatosis grades 0 vs. 1–3, 0–1 vs. 2–3, and 0–2 vs. 3 were compared and analyzed.

Results

A total of 6 studies were included in this meta-analysis (n = 635). The summary AUROC values of MRI-PDFF for classifying steatosis grades 0 vs. 1–3, 0–1 vs. 2–3, and 0–2 vs. 3 were 0.98, 0.91, and 0.90, respectively. Pooled sensitivity and specificity of MRI-PDFF for classifying steatosis grades 0 vs. 1–3, 0–1 vs. 2–3, and 0–2 vs. 3 were 0.93 and 0.94, 0.74 and 0.90, and 0.74 and 0.87, respectively. Summary +LR and −LR of MRI-PDFF for classifying steatosis grades 0 vs. 1–3, 0–1 vs. 2–3, and 0–2 vs. 3 were 16.21 (95%CI, 4.72–55.67) and 0.08 (95%CI, 0.04–0.15), 7.19 (95%CI, 5.04–10.26) and 0.29 (95%CI, 0.22–0.38), and 5.89 (95%CI, 4.27–8.13) and 0.29 (95%CI, 0.21–0.41), respectively.

Conclusions

Our meta-analysis suggests that MRI-PDFF has excellent diagnostic value for assessment of hepatic fat content and classification of histologic steatosis in patients with NAFLD.

Key Points

• MRI-PDFF has significant diagnostic value for hepatic steatosis in patients with NAFLD.

• MRI-PDFF may be used to classify grade of hepatic steatosis with high sensitivity and specificity.

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Abbreviations

95%CI:

95% confidence interval

ARFI:

Acoustic radiation force impulse

AUROC:

Areas under summary receiver operating characteristic curves

BMI:

Body mass index

CAP:

Controlled attenuation parameter

CRN:

Clinical Research Network

DOR:

diagnostic odds ratio

ElastPQ:

Elastography point quantification

HCC:

Hepatocellular carcinoma

LR:

Likelihood ratio

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy

NAFLD:

Non-alcoholic fatty liver disease

NASH:

Non-alcoholic steatohepatitis

PDFF:

Proton density fat fraction

pSWE:

Point shear wave elastography

QUADAS:

Quality assessment of diagnostic accuracy studies

ROC:

Receiver operating characteristic

TE:

Transient elastography

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Funding

This study has received funding by the National Natural Science Foundation of China (No. 31770837) and the Qingdao, Shinan District Science and Technology Development Project Fund (No. 2016-3-016-YY).

Author information

Author notes

  1. Jiulian Gu and Shousheng Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao, 266011, China

    Jiulian Gu, Shuixian Du & Yongning Xin

  2. Medical College of Qingdao University, Qingdao, 266071, China

    Jiulian Gu & Jianhan Xiao

  3. Central Laboratories, Qingdao Municipal Hospital, Qingdao, 266071, China

    Shousheng Liu & Quanjiang Dong

  4. Digestive Disease Key Laboratory of Qingdao, Qingdao, 266071, China

    Shousheng Liu & Yongning Xin

  5. Department of Gastroenterology, Qingdao Municipal Hospital, 1 Jiaozhou Road, Qingdao, 266011, Shandong Province, China

    Shuixian Du & Yongning Xin

  6. Department of Radiology, Qingdao Municipal Hospital, Qingdao, 266071, China

    Qing Zhang

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  1. Jiulian Gu
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Correspondence to Yongning Xin.

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Guarantor

The scientific guarantor of this publication is Yongning Xin.

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

Qing Zhang as an expert in statistics and radiology, who worked at Qingdao Municipal Hospital, gave us much guidance of statistics and biometry.

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Written informed consent was not required for this study because this study was a meta-analysis.

Ethical approval

Institutional Review Board approval was not required because this study was a meta-analysis.

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• Retrospective

• Multicenter study

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Gu, J., Liu, S., Du, S. et al. Diagnostic value of MRI-PDFF for hepatic steatosis in patients with non-alcoholic fatty liver disease: a meta-analysis. Eur Radiol 29, 3564–3573 (2019). https://doi.org/10.1007/s00330-019-06072-4

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