Magnetic resonance elastography for the early detection and staging of liver fibrosis in chronic hepatitis B: A systematic review and meta-analysis

OBJECTIVE: This study aimed to perform a systematic review and meta-analysis to evaluate the diagnostic efficacy and establish thresholds of magnetic resonance elastography (MRE) for assessing different stages of liver fibrosis in individuals with chronic hepatitis B (CHB). MATERIALS AND METHODS: The study was performed in PubMed, Web of Science, Embase, CNKI, WANFANG, and SinoMed until April 2024. Two authors independently screened and assessed the methodological quality of studies and extracted data. QUADAS-2 tool was used to evaluate the risk of bias. A meta-analysis was conducted to calculate the pooled effect size using a fixed-effect model or a random-effects model by RStudio. RESULTS: Thirteen studies were included in the analysis. MRE for liver fibrosis staging in CHB patients demonstrated an accuracy of 0.97 (95% confidence interval [CI] =0.96–0.99), sensitivity of 0.98 (95% CI = 0.95–1.00), and specificity of 0.96 (95% CI = 0.92–1.00). Moreover, for CHB patients at stage F2 of liver fibrosis, there was a statistically significant difference in MRE thresholds between 1.5 T and 3 T ( P < 0.05). CONCLUSIONS: MRE has high accuracy in the early detection and staging of CHB-induced liver fibrosis. The threshold of MRE based on field strengths should be further discussed and determined to improve the clinical applicability of MRE in the staging diagnosis of liver fibrosis caused by CHB.