Comparison of Two-Dimensional Shear Wave Elastography and Point Shear Wave Elastography for Assessing Liver Fibrosis

Abstract Background: Progressive liver fibrosis may result in cirrhosis, portal hypertension, and hepatocellular carcinoma (HCC). We performed a meta-analysis to compare liver fibrosis staging in chronic liver disease patients using two-dimensional shear wave elastography (2D-SWE) and point shear wave elastography (pSWE). Methods: PubMed, Web of Science, and Cochrane Library databases were searched until September 30th 2019 for studies evaluating the diagnostic performance of 2D-SWE and pSWE for assessing liver fibrosis. Pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios, and area under receiver operating characteristic curve (AUC) were estimated using the bivariate random effects model. Results: Eighteen studies with 3,082 patients were included in the analysis. The pooled sensitivities of 2D-SWE and pSWE were significantly different for the detection of significant fibrosis (0.83 vs. 0.70, P < 0.001) and advanced fibrosis (0.89 vs. 0.78, P 0.05). The pooled specificities of 2D-SWE and pSWE were not significantly different for detection of significant fibrosis (0.83 vs. 0.83, P > 0.05), advanced fibrosis (0.80 vs. 0.85, P > 0.05), or cirrhosis (0.84 vs. 0.88, P > 0.05). Conclusions: Both 2D-SWE and pSWE have high sensitivity and specificity for detecting each stage of liver fibrosis. 2D-SWE has higher sensitivity than pSWE for detection of significant fibrosis and advanced fibrosis. Large-scale and multi-center studies are needed to directly compare 2D-SWE and pSWE.