Original Title: Efectividad diagnóstica y seguridad de la elastografía en el estudio de fibrosis hepática en enfermedad hepática crónica

Authors' objectives: To review the available scientific evidence on the diagnostic effectiveness and/or clinical utility of FRA-based ultrasound elastography compared to TE for the detection and assessment of the progression of liver fibrosis in patients with chronic liver disease

Authors' results and conclusions: The scientific evidence available in SR, MA and IETS on the comparative diagnostic performance between ET, pSWE and SWE in the study of the degree of liver fibrosis is very scarce, and the evidence seems to show that pSWE and SWE would have a similar diagnostic effectiveness to ET in the diagnosis and staging of fibrosis. These techniques have demonstrated some diagnostic ability to differentiate between significant and mild fibrosis, but their greatest clinical utility would be to rule out the presence of cirrhosis. As with ET, these other elastographic techniques have been applied primarily in patients with HCC. They could also be useful to rule out cirrhosis in patients with BCH, NAFLD and ALD, although in these patients other confounding factors need to be taken into account as they are more likely to interfere with the elastographic test results than in cases of CHC. The literature reviewed shows that there is great heterogeneity between the populations studied and the aetiology of liver disease. The main clinical utility of these diagnostic tests could be to reduce the number of liver biopsies. There is no consensus on the usefulness of elastographic techniques in fibrosis monitoring. Nor is there agreement in the literature on the prognostic role of these techniques in patients with advanced fibrosis or cirrhosis. It would be interesting to perform a systematic review of primary studies using these elastographic techniques applied to the study of liver fibrosis and meta-analysis of the results, either of direct comparisons or, if there are none, of indirect comparisons, with the appropriate methodology to establish the effectiveness of each technique and specify the optimal cut-offs. Meta-analysis could also help to establish the clinical utility and to determine the prognostic and predictive value of possible complications and the possibility of death associated with cirrhosis and advanced liver disease.

Authors' methods: Systematic Review and Meta-analysis

Project Status: Completed

Year Published: 2018

URL for published report: https://redets.sanidad.gob.es/productos/buscarProductos.do?metodo=detalle&id=909

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion