Title: The diagnostic accuracy of US, CT, MR-imaging and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: A meta-analysis
Journal name: European Radiology
Authors:
Anneloes E. Bohte, MD. Corresponding author ()
Jochem R. van Werven, MD
Shandra Bipat, PhD
Jaap Stoker, MD, PhD
Institution:
Department of Radiology
Academic Medical Center
University of Amsterdam
Meibergdreef 9
1105 AZ Amsterdam
The Netherlands
ESM 7: US accuracy
Steatosis on biopsy / Study / Cut-off / Disease present / Disease not present / Sensitivity (%) / Specificity (%)TP / FN / FP / TN
>0% / Saverymuttu 1986 / Visual evaluation: any steatosis / 45 / 3 / 6 / 31 / 93.8 / 83.8
Joseph 1991 / Visual evaluation: any steatosis / 32 / 4 / 1 / 13 / 88.9 / 92.9
Hultcrantz 1993 / Visual evaluation: any steatosis / 37 / 8 / 19 / 19 / 82.2 / 50.0
Dietrich 1998 / Visual evaluation: any steatosis / 26 / 10 / 0 / 32 / 72.2 / 100
Graif 2000 / Visual evaluation score 0-3 (Reader 1) / 12 / 3 / 4 / 9 / 80.0 / 69.2
Graif 2000 / Visual evaluation score 0-3 (Reader 2) / 9 / 2 / 5 / 8 / 81.8 / 61.5
Graif 2000 / Visual evaluation score 0-3 (Reader 3) / 9 / 2 / 5 / 8 / 81.8 / 61.5
Graif 2000 / Far field slope algorithm / - / - / - / - / 67 / 77
Kutcher 1998 / Visual evaluation: any steatosis / 14 / 18 / 8 / 24 / 43.8 / 75.0
Mathiesen 2002 / Visual evaluation: echogeneity score 2-3-4 / 97 / 42 / 1 / 25 / 69.8 / 96.2
Kichian 2003 / Visual evaluation: any steatosis / 22 / 12 / - / - / 64.7 / -
Perez 2007 / Visual evaluation / 16 / 34 / 28 / 53 / 32.0 / 65.4
>2% / Hepburn 2005 / Visual evaluation: any steatosis / 28 / 37 / 12 / 45 / 43.1 / 78.9
Palmentieri 2006 / Visual evaluation: bright liver / 81 / 46 / 3 / 86 / 63.8 / 96.6
>5% / Korte, de 1986 / Visual evaluation: any steatosis / 92 / - / 8 / - / - / -
Kim SH 2005 / Visual evaluation: any steatosis
(total of 3 readers) / 133 / 31 / 23 / 95 / 81.1 / 80.5
Lee JY 2007 / Visual evaluation: any steatosis / 149 / 148 / 25 / 255 / 50.2 / 91.1
Chen 2008 / Visual evaluation: any steatosis / 27 / 11 / 19 / 51 / 71.1 / 72.9
Moura Almeida de 2008 / Visual evaluation: any steatosis / 61 / 33 / 1 / 10 / 64.9 / 90.9
Crum-Cianflone 2009 / Visual evaluation: any steatosis / 17 / 3 / 10 / 25 / 85.0 / 71.4
Dasarathy 2009 / Visual evaluation: any steatosis / ND / ND / ND / ND / 82.4 / 100
Webb 2009 / HR index >1.49b / 45 / 0 / 6 / 60 / 100 / 90.9
Summary estimates (±95% CI) / 73.3 (62.2 -82.1) / 84.4 (76.2-90.1)
>10% / Lossner 1988 / Visual evaluation: mild/moderate/severe / 143 / 4 / 15 / 18 / 97.3 / 54.5
Hamaguchi 2007 / Visual grading: score ≥ 2a (Reader 1) / 63 / 5 / - / - / 92.6 / 100
Hamaguchi 2007 / Visual grading: score ≥ 2a (Reader 2) / 62 / 6 / - / - / 91.2 / 100
Tobari 2009 / Visual evaluation: ≥2 of: increased HRC; BL; PBA; VB. / 94 / 24 / - / - / 79.7 / -
Yamashiki 2009 / Visual evaluation / 7 / 2 / 16 / 53 / 77.8 / 76.8
>20% / Dasarathy 2009 / Visual evaluation / ND / ND / ND / ND / 96.4 / 97.8
Summary estimates (±95% CI) / 90.5 (79.3-96.0) / 69.6 (60.0-77.7)
>25% / Joseph 1991 / Visual evaluation: any steatosis / 20 / 1 / 13 / 16 / 95.2 / 55.2
Hirche 2007 / Visual evaluation: hyopechoic areas in liver hilum / 53 / 19 / 0 / 50 / 73.6 / 100
Webb 2009 / HR Index >1.86b / 27 / 3 / 8 / 73 / 90.0 / 90.1
>30% / Yajima 1983 / Visual evaluation / 10 / 2 / 0 / 33 / 83.3 / 100
Lossner 1988 / Visual evaluation: moderate/severe / 82 / 14 / 25 / 59 / 85.4 / 70.2
Caturelli 1992 / Visual evaluation: moderate/severe / 29 / 4 / 0 / 2 / 87.9 / 100
Hepburn 2005 / Visual evaluation: any steatosis / 12 / 8 / 28 / 74 / 60.0 / 72.5
Kim SH 2005 / Visual evaluation: moderate/severe
(total of 3 readers) / 49 / 5 / 49 / 179 / 90.7 / 78.5
Palmentieri 2006 / Visual evaluation: bright liver / 64 / 7 / 10 / 135 / 90.1 / 93.1
Lee JY 2007 / Visual evaluation: steatosis / 60 / 5 / 114 / 398 / 92.3 / 77.7
Chen 2008 / Visual evaluation / 6 / 1 / 40 / 61 / 85.7 / 60.4
Dasarathy 2009 / Visual evaluation / ND / ND / ND / ND / 100 / 84.9
>33% / Korte, de 1986 / Visual evaluation: any fat / 40 / - / 60 / - / - / -
Mathiesen 2002 / Visual evaluation: echogeneity score 2-3-4 / 85 / 9 / 13 / 58 / 90.4 / 81.7
Mathiesen 2002 / Visual evaluation: echogeneity score 2-3-4 + posterior beam attenuation / ND / ND / ND / ND / 65.0 / 69.0
Mathiesen 2002 / Visual evaluation: echogeneity score 2-3-4 + vessel blurring / 74 / 11 / 5 / 8 / 87.1 / 61.5
Saadeh 2002 / Visual evaluation: increased echogenicity, vessel blurring / ND / ND / ND / ND / 100 / -
Perez 2007 / Visual evaluation / 5 / 12 / 16 / 98 / 29.4 / 85.7
Crum-Cianflone 2009 / Visual evaluation: moderate/severe echogenicity diffusion / 1 / 0 / 11 / 43 / 100 / 79.6
Yu 2009 / Visual evaluation: moderate/severe / 106 / 5 / 2 / 58 / 95.5 / 96.7
moderate/severe / Graif 2000 / Visual evaluation: score 2-3 (Reader 1) / 8 / 3 / 3 / 14 / 72.7 / 82.4
Graif 2000 / Visual evaluation: score 2-3 (Reader 2) / 6 / 2 / 2 / 14 / 75.0 / 87.5
Graif 2000 / Visual evaluation: score 2-3 (Reader 3) / 7 / 1 / 4 / 12 / 87.5 / 75.0
Summary estimates (±95% CI) / 85.7 (78.4-90.8) / 85.2 (76.9-90.9)
>50% / Joseph 1991 / Visual evaluation; any steatosis / 7 / 0 / 26 / 17 / 100 / 39.5
Hirche 2007 / Visual evaluation: hyopechoic areas in liver hilum / 44 / 0 / 9 / 69 / 100 / 88.5
Dasarathy 2009 / Visual evaluation / - / - / - / - / 100 / 72.6
severe / Graif 2000 / Visual evaluation: score 3 (Reader 1) / 2 / 1 / 3 / 22 / 66.7 / 88.0
Graif 2000 / Visual evaluation: score 3 (Reader 2) / 2 / 0 / 2 / 20 / 100 / 90.9
Graif 2000 / Visual evaluation: score 3 (Reader 3) / 2 / 0 / 5 / 17 / 100 / 77.3
>60% / Kim SH 2005 / Visual evaluation: severe (total of 3 readers) / 11 / 4 / 41 / 226 / 73.3 / 84.6
Webb 2009 / HR Index >2.23b / 18 / 2 / 6 / 85 / 90.0 / 93.4
>66 % / Mathiesen 2002 / Visual evaluation: echogeneity score 4 / 14 / 59 / 0 / 92 / 19.2 / 100
Yu 2009 / Visual evaluation: severe / 38 / 4 / 3 / 126 / 90.5 / 97.7
Summary estimates (±95% CI) / 91.1 (63.0-98.4) / 91.9 (74.3-97.8)
Note.— NA: Not applicable; ND: Not defined; HRC: Hepatorenal contrast; VB: Vessel blurring; PBA: Posterior beam attenuation; BL: Bright liver.
aBright liver/increased hepatorenal contrast (score 0-3); Vascular blurring (score 0-1); posterior beam attenuation (score 0-2)
bHR index: liver brightness/ kidney brightness.