Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis.

AIM: To investigate the clinical utility of shear wave elastography (SWE) imaging in the identification of malignant and benign lesions of the liver lesions by conducting a meta-analysis.

MATERIAL AND METHODS: The Cochrane library, Embase and Pubmed were searched for relevant studies with publication data through February 2016. Studies evaluating the diagnostic accuracy of SWE in the identification of malignant and benign lesions of the liver using SWE technology were selected. The cytology, histology or clinical imaging was used as the reference standard. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under hierarchical summary receiver operating characteristic curve (HSROC) were used to examine the diagnostic accuracy.

RESULTS: A total of 9 cohort studies involving 1046 liver lesions (malignant 679) from 968 patients were identified. All of the 9 studies were prospective studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of SWE in differentiating malignant and benign liver lesions were 82.2% (95% CI: 73.4-88.5), 80.2% (95% CI: 73.3-85.7), 4.159 (95% CI: 2.899-5.966), 0.222 (95% CI: 0.140-0.352), and 18.749 (95% CI: 8.746-40.195), respectively. The area under the HSROC curve was 87% (95% CI: 84-90).

CONCLUSIONS:  This meta-analysis indicates that SWE is useful in evaluating the stiffness of liver lesions and in differentiating between malignant and benign lesions. Due to the high sensitivity, specificity, and diagnostic odds ratio, SWE can be considered as a useful complement to conventional ultrasonography.