Accuracy of 2D and point shear wave elastography-based measurements for diagnosis of esophageal varices: a systematic review and meta-analysis

Abstract

The aim of this meta-analysis is to summarize the diagnostic accuracies of point shear wave elastography (pSWE) and two-dimensional (2D) SWE for esophageal varices (EV) and varices needing treatment (VNT). METHODS We conducted a systematic review and meta-analysis of diagnostic accuracy studies. We searched for studies reporting the EV and VNT diagnostic accuracy of pSWE and 2D SWE using PubMed Central, SCOPUS, MEDLINE, Embase, and Cochrane databases. STATA software “Midas” package was used for meta-analysis. RESULTS A total of 24 studies with 3867 patients were included in the review. Pooled score sensitivities of pSWE were 91% (95% CI, 80%-96%) for EV, and 94% (95% CI, 86%-97%) for VNT. Pooled score sensitivities of 2D SWE were 78% (95% CI, 69%-85%) for EV, and 79% (95% CI, 72%-85%) for VNT. Pooled score specificities of pSWE were 70% (95% CI, 60%-78%) for EV, and 59% (95% CI, 40%-75%) for VNT. Pooled score specificities of 2D SWE for EV were 79% (95% CI, 72%-85%) 72% (95% CI, 66%-77%) for VNT. We found significant heterogeneity for all the elastography-based measurements with the chisquare test results and an I2 statistic >75%. CONCLUSION Both pSWE and 2D SWE can diagnose EV and VNT with moderate diagnostic accuracy. Further largescale setting-specific longitudinal studies are required to establish the best modality.