Diagnostic performance of point shear wave elastography and vibration-controlled transient elastography in paediatric metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis
Objective This study aimed to comprehensively assess the diagnostic accuracy of point shear wave elastography (pSWE) and vibration-controlled transient elastography (VCTE) in paediatric metabolic dysfunction-associated steatotic liver disease (MASLD).Design Systematic review and meta-analysis of dia...
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BMJ Publishing Group
2025-06-01
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| author | Jun Li Ze-Lin Xu Si-Rui Wang Wen-Xiao Li Ya-Qian Deng Yan-Fei Kang Yu-Rui Zhang Xin-Wu Cui |
| author_facet | Jun Li Ze-Lin Xu Si-Rui Wang Wen-Xiao Li Ya-Qian Deng Yan-Fei Kang Yu-Rui Zhang Xin-Wu Cui |
| author_sort | Jun Li |
| collection | DOAJ |
| description | Objective This study aimed to comprehensively assess the diagnostic accuracy of point shear wave elastography (pSWE) and vibration-controlled transient elastography (VCTE) in paediatric metabolic dysfunction-associated steatotic liver disease (MASLD).Design Systematic review and meta-analysis of diagnostic test accuracy using the Grading of Recommendations Assessment, Development and Evaluation approach with random-effects models.Data sources PubMed, Embase, Web of Science, Ovid (Medline), Cochrane, China National Knowledge Infrastructure, Wan Fang and OpenGrey were searched for publications from April 1989 to July 2024.Eligibility criteria The study included relevant records on the application of pSWE and VCTE in diagnosing MASLD in children (<19 years). These studies evaluated the diagnostic performance (sensitivity, specificity, area under the receiver operating characteristic curve) of two techniques for paediatric MASLD in the context of a relative gold standard with no language barriers. Studies of children with concurrent liver diseases were excluded.Data extraction and synthesis Two independent reviewers extracted data and assessed the risk of bias. Articles were assessed using Quality Assessment of Diagnostic Accuracy Studies 2 for diagnostic accuracy and potential biases, and bias risks were visually represented using the Risk of Bias Visualisation tool. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). The analysis of the likelihood ratio graph (Fagan plot) indicates that both pSWE and VCTE provide valuable diagnostic support for MASLD.Results The comprehensive literature search yielded four pSWE studies encompassing 968 children and seven VCTE studies encompassing 1934 children. In our meta-analysis, VCTE had a sensitivity of 0.89 (95% CI, 0.79 to 0.94) and a specificity of 0.90 (95% CI, 0.83 to 0.95), which showed superior diagnostic accuracy compared with pSWE (sensitivity, 0.89 (95% CI, 0.81 to 0.94); specificity, 0.85 (95% CI, 0.81 to 0.89)).Conclusion While both pSWE and VCTE demonstrated appreciable diagnostic efficacy in paediatric MASLD, VCTE showed similar sensitivity but superior specificity, emerging as the more effective technique particularly in non-obese children. However, further investigation is warranted to fully elucidate the influence of probe selection and racial prevalence on these diagnostic modalities.PROSPERO registration number CRD42024514246. |
| format | Article |
| id | doaj-art-d0b0f41c6a0141ba9aaedf9020faadc2 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-d0b0f41c6a0141ba9aaedf9020faadc22025-08-20T03:21:51ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-087101Diagnostic performance of point shear wave elastography and vibration-controlled transient elastography in paediatric metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysisJun Li0Ze-Lin Xu1Si-Rui Wang2Wen-Xiao Li3Ya-Qian Deng4Yan-Fei Kang5Yu-Rui Zhang6Xin-Wu Cui7Department of Ultrasound, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, People`s Republic of ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, People`s Republic of ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, People`s Republic of ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, People`s Republic of ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, People`s Republic of ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, People`s Republic of ChinaDepartment of Ultrasound, The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, People`s Republic of ChinaDepartment of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People`s Republic of ChinaObjective This study aimed to comprehensively assess the diagnostic accuracy of point shear wave elastography (pSWE) and vibration-controlled transient elastography (VCTE) in paediatric metabolic dysfunction-associated steatotic liver disease (MASLD).Design Systematic review and meta-analysis of diagnostic test accuracy using the Grading of Recommendations Assessment, Development and Evaluation approach with random-effects models.Data sources PubMed, Embase, Web of Science, Ovid (Medline), Cochrane, China National Knowledge Infrastructure, Wan Fang and OpenGrey were searched for publications from April 1989 to July 2024.Eligibility criteria The study included relevant records on the application of pSWE and VCTE in diagnosing MASLD in children (<19 years). These studies evaluated the diagnostic performance (sensitivity, specificity, area under the receiver operating characteristic curve) of two techniques for paediatric MASLD in the context of a relative gold standard with no language barriers. Studies of children with concurrent liver diseases were excluded.Data extraction and synthesis Two independent reviewers extracted data and assessed the risk of bias. Articles were assessed using Quality Assessment of Diagnostic Accuracy Studies 2 for diagnostic accuracy and potential biases, and bias risks were visually represented using the Risk of Bias Visualisation tool. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). The analysis of the likelihood ratio graph (Fagan plot) indicates that both pSWE and VCTE provide valuable diagnostic support for MASLD.Results The comprehensive literature search yielded four pSWE studies encompassing 968 children and seven VCTE studies encompassing 1934 children. In our meta-analysis, VCTE had a sensitivity of 0.89 (95% CI, 0.79 to 0.94) and a specificity of 0.90 (95% CI, 0.83 to 0.95), which showed superior diagnostic accuracy compared with pSWE (sensitivity, 0.89 (95% CI, 0.81 to 0.94); specificity, 0.85 (95% CI, 0.81 to 0.89)).Conclusion While both pSWE and VCTE demonstrated appreciable diagnostic efficacy in paediatric MASLD, VCTE showed similar sensitivity but superior specificity, emerging as the more effective technique particularly in non-obese children. However, further investigation is warranted to fully elucidate the influence of probe selection and racial prevalence on these diagnostic modalities.PROSPERO registration number CRD42024514246.https://bmjopen.bmj.com/content/15/6/e087101.full |
| spellingShingle | Jun Li Ze-Lin Xu Si-Rui Wang Wen-Xiao Li Ya-Qian Deng Yan-Fei Kang Yu-Rui Zhang Xin-Wu Cui Diagnostic performance of point shear wave elastography and vibration-controlled transient elastography in paediatric metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis BMJ Open |
| title | Diagnostic performance of point shear wave elastography and vibration-controlled transient elastography in paediatric metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis |
| title_full | Diagnostic performance of point shear wave elastography and vibration-controlled transient elastography in paediatric metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis |
| title_fullStr | Diagnostic performance of point shear wave elastography and vibration-controlled transient elastography in paediatric metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis |
| title_full_unstemmed | Diagnostic performance of point shear wave elastography and vibration-controlled transient elastography in paediatric metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis |
| title_short | Diagnostic performance of point shear wave elastography and vibration-controlled transient elastography in paediatric metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis |
| title_sort | diagnostic performance of point shear wave elastography and vibration controlled transient elastography in paediatric metabolic dysfunction associated steatotic liver disease a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/15/6/e087101.full |
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