Systematic Reviews
Copyright ©The Author(s) 2025.
World J Hepatol. Feb 27, 2025; 17(2): 100033
Published online Feb 27, 2025. doi: 10.4254/wjh.v17.i2.100033
Table 1 Scheuer to METAVIR conversion (fibrosis)
Scheuer
METAVIR
S0 (no fibrosis)F0
S1 (portal fibrosis)F1
S2 (periportal fibrosis, few septa)F2
S3 (numerous septa without cirrhosis)F3
S4 (cirrhosis)F4
Table 2 2D-shear wave elastography diagnostic efficacy (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Fang et al[25]121CLD2D-SWEF ≥ 20.884 (0.817-0.951)Good
F ≥ 30.926 (0.88-0.973)Excellent
Aksakal et al[20]103CHB/CHC2D-SWEF ≥ 10.85 (0.75-0.94)Good
F ≥ 20.98 (0.94-1.00)Excellent
F ≥ 30.97 (0.94-1.00)Excellent
F ≥ 40.94 (0.89-1.00)Excellent
Alcantara-Diaz et al[21]227Obesity2D-SWEF ≥ 20.54 (0.47-0.62)Unacceptable
F ≥ 3 (whole)0.73 (0.60-0.87)Acceptable
F ≥ 3 (women)0.82 (0.59-1.00)Good
F ≥ 3 (morbid obesity)0.78 (0.61-0.99)Acceptable
Imajo et al[66]231NAFLD2D-SWEF40.88 (0.83-0.92)Good
Jocius et al[28]72CLD2D-SWEF1 vs F2-F40.75Acceptable
F1-F2 vs F3-F40.93Excellent
F1-F3 vs F40.91Excellent
Lee et al[31]87CLD2D-SWE≥ F20.965 (0.895-0.993)Excellent
F40.994 (0.943-1.00)Excellent
Manesis et al[32]53PBC2D-SWEF10.874Good
F20.853Good
F30.953Excellent
F40.953Excellent
Martonik et al[33]231HBV/HCV2D-SWEF0-F1 vs ≥ F20.83Good
F2 vs ≥ F30.84Good
F3 vs F40.94Excellent
Mendoza et al[34]200NAFLD2D-SWE≥ F20.83 (0.72-0.93)Good
≥ F30.84 (0.76-0.92)Good
F40.94 (0.89-0.99)Excellent
Paisant et al[38]788Liver fibrosis2D-SWE>F20.825 (SD ± 0.006)Good
F40.880 (SD ± 0.006)Good
Prieto Ortiz et al[68]453Liver fibrosis2D-SWEF > 10.75Acceptable
F > 20.83Good
F > 30.89Good
F = 40.94Excellent
Seyrek et al[42]146CLD2D-SWE> F20.86 (0.75-0.96)Good
> F30.87 (0.78-0.97)Good
F2-F40.84 (0.76-0.92)Good
F40.93 (0.86-0.99)Excellent
Sharpton et al[43]114CLD2D-SWEF2-F40.84 (0.76-0.92)Good
F3-F40.88 (0.81-0.96)Good
F40.93 (0.86-0.99)Excellent
Soh et al[44]69AIH2D-SWE≥ F20.903 (0.807-0.961)Excellent
≥ F30.815 (0.703-0.898)Good
F40.854 (0.748-0.927)Good
Song et al[45]602CHB2D-SWE≥ F10.807 (0.742-0.861)Good
≥ F20.868 (0.810-0.914)Good
≥ F30.855 (0.796-0.903)Good
F40.851 (0.791-0.900)Good
Wang et al[47]141AIH-PBC2D-SWEF2-F40.748 (0.668-0.817)Acceptable
F3-F40.818 (0.745-0.878)Good
F40.879 (0.813-0.928)Good
Yan et al[69]148AIH-PBC2D-SWE≥ F20.91 (0.85-0.96)Excellent
≥ F30.97 (0.94-0.99)Excellent
F40.96 (0.92-0.99)Excellent
Yoo et al[52]115CLD2D-SWEF20.851 (0.773-0.911)Good
F30.917 (0.851-0.960)Excellent
F40.889 (0.817-0.940)Good
Yamaoka et al[54]116CLD2D-SWE≥ F20.85 (0.773-0.911)Good
≥ F30.91 (0.81-0.97)Excellent
F40.88 (0.79-1.00)Good
Zhou et al[64]116NAFLD2D-SWE≥ F20.86 (0.77-0.94)Good
≥ F30.89 (0.81-0.97)Good
F40.90 (0.79-1.00)Good
Table 3 2D-shear wave elastography diagnostic efficacy (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Yoo et al[52]203CLD2D-SWE LOGIQ E9F20.910 (0.871-0.944)Excellent
F30.897 (0.844-0.939)Good
F40.931 (0.874-0.969)Excellent
2D-SWE LOGIQ S8F20.908 (0.874-0.940)Excellent
F30.905 (0.864-0.954)Excellent
F40.931 (0.889-0.964)Excellent
Kavak et al[29]253CHB2D-SWE-MPGF > 20.956 (0.920-0.991)Excellent
F > 30.978 (0.945-1.000)Excellent
Garcovich et al[26]253CLD2D-SWE-SSIF ≥ 20.96 (0.93-0.99)Excellent
F ≥ 30.98 (0.97-1.00)Excellent
F40.99 (0.98-1.00)Excellent
Cassinotto et al[23]577NAFLD2D-SWE-SSIF ≥ 20.84 (0.81-0.88)Exclusion
F ≥ 30.88 (0.84-0.91)Excellent
F40.86 (0.82-0.90)Excellent
Table 4 Point-shear wave elastography diagnostic efficacy (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Lee et al[31]87CLDp-SWE≥ F20.872 (0.777-0.937)Good
F40.886 (0.794-0.947)Good
Fang et al[25]121CLDp-SWE≥ F20.855 (0.778-0.932)Good
≥ F30.890 (0.826-0.954)Good
Saadi et al[41]216CLDp-SWEF0-F10.744 (0.67-0.82)Acceptable
F30.82 (0.74-0.89)Good
F40.95 (0.91-0.98)Acceptable
Atzori et al[22]160CLDp-SWE - Philips ElastPQF0/10.828 (0.762-0.895)Good
F3/40.812 (0.734-0.889)Good
F40.856 (0.753-0.938)Good
Atzori et al[22]160CLDp-SWE - Siemens VTQF0/10.741 (0.659-0.823)Acceptable
F3/40.782 (0.702-0.861)Acceptable
F40.826 (0.734-0.918)Good
Roccarina et al[40]671NAFLDp-SWE by ElastPQF > 10.835 (0.72-0.93)Good
F > 20.831 (0.78-0.90)Good
F > 30.864 (0.82-0.93)Good
F = 40.952 (0.92-0.99)Excellent
Garcovich et al[26]253CLDX + p-SWEF ≥ 20.96 (0.93-0.99)Excellent
F ≥ 30.98 (0.97-1.00)Excellent
F40.99 (0.98-1.00)Excellent
Table 5 Shear wave elastography diagnostic efficacy (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Gatos et al[27]152CLDSWEF ≥ F10.9621Excellent
F ≥ F20.9931Excellent
F ≥ F30.9835Excellent
F = F40.9656Excellent
F00.995 (0.988-1.00)Excellent
F10.676 (0.589-0.763)Unacceptable
F20.507 (0.409-0.605)Unacceptable
F30.708 (0.621-0.795)Good
F40.932 (0.889-0.975)Excellent
Laroia et al[30]124CLDSWECombined F1 + F20.612 (0.516-0.708)Unacceptable
Combined F3 + F40.961 (0.933-0.990)Excellent
Ogino e t al[37]107NAFLDSWEF20.88Good
F30.87Good
F40.92Excellent
Zhang et al[70]100NAFLDSWE≥ 10.65 (0.54-0.76)Unacceptable
≥ 20.81 (0.71-0.91)Good
≥ 30.85 (0.74-0.96)Good
40.91 (0.79-1.00)Excellent
Wang et al[49]210HCCSWE≥ F20.895 (0.842-0.947)Good
≥ F30.877 (0.826-0.927)Good
= F40.854 (0.803-0.905)Good
Zougmoré et al[55]476CLDSWE≥ F20.91 (0.88-0.96)Excellent
≥ F30.93 (0.89-0.97)Excellent
≥ F40.96 (0.94-0.98)Excellent
Kim et al[67]60NASHSWE≥ F10.777 (0.653-0.777)Acceptable
≥ F20.747 (0.611-0.854)Acceptable
≥ F30.861 (0.742-0.940)Good
≥ F40.846 (0.730-0.926)Good
Yang et al[50]106CLDSWEF0 vs F1-30.91Excellent
F0-1 vs F2-40.84Good
F0-2 vs F3-40.79Acceptable
F0-3 vs F40.76Acceptable
Table 6 Modified or specific shear wave elastography modalities’ diagnostic efficacy (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Patidar et al[39]127Diffuse liver diseasesRT-SWEF0-F10.867 (0.72-1)Good
F1-F20.955 (0.906-1Excellent
F2-F30.946 (0.883-1)Excellent
F3-F40.93 (0.633-1)Excellent
Wang et al[48]524CHBSTQF > 40.86Good
F > 20.73Acceptable
Taibbi et al[46]56NAFLDSWE (10 measurements)F2-F40.787 (0.646-0.927)Acceptable
F3-F40.797 (0.659-0.935)Acceptable
SWE (5 measurements)F2-F40.809 (0.676-0.942)Good
F3-F40.809 (0.684-0.933)Good
SWE (3 measurements)F2-F40.714 (0.560-0.869)Acceptable
F3-F40.736 (0.587-0.885)Acceptable
Table 7 Transient elastography diagnostic efficacy (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Mendoza et al[34]200NAFLDTE≥ F20.76 (0.64-0.88)Acceptable
≥ F30.72 (0.63-0.82)Acceptable
F40.89 (0.78-1.00)Good
Patidar et al[39]127Diffuse liver diseasesTEF0-F10.824 (0.72-1)Good
F1-F20.935 (0.906-1)Good
F2-F30.964 (0.883-1)Good
F3-F40.979 (0.633-1)Good
Seyrek et al[42]146CLDTE> F20.79 (0.65-0.94)Acceptable
Taibbi et al[46]56NAFLDTEF2-F40.719 (0.572-0.867)Acceptable
F3-F40.799 (0.646-0.952)Acceptable
Yoo et al[52]115CLDTEF20.859 (0.781-0.916)Good
F30.881 (0.807-0.934)Good
F40.938 (0.877-0.974)Excellent
Kim et al[67]60NASHTE≥ F10.733 (0.603-0.839)Acceptable
≥ F20.828 (0.709-0.913)Good
≥ F30.869 (0.756-0.942)Good
≥ F40.891 (0.783-0.957)Good
Table 8 Vibration-controlled transient elastography diagnostic efficacy (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Cassinotto et al[23]577NAFLDVCTEF ≥ 20.80 (0.76-0.84)Acceptable
F ≥ 30.82 (0.78-0.86)Good
F40.85 (0.80-0.90)Good
Gatos et al[27]152CLDVCTEF ≥ F10.9900Excellent
F ≥ F20.9767Excellent
F ≥ F30.9651Excellent
F = F40.9645Excellent
Imajo et al[66]231NAFLDVCTEF40.87 (0.80-0.91)Good
Nogami et al[36]163NAFLDVCTE≥ F20.855 (0.83-0.94)Good
≥ F30.925 (0.90-0.95)Excellent
F40.88 (0.87-0.89)Good
Sharpton et al[43]114CLDVCTEF2-F40.86 (0.80-0.93)Good
F3-F40.91 (0.82-0.99)Excellent
F40.96 (0.91-1.00)Excellent
Atzori et al[22]160CLDVCTEF0/10.810 (0.746-0.884)Good
F3/40.841 (0.771-0.910)Good
F40.939 (0.896-0.982)Excellent
Damjanovska et al[24]93NAFLDVCTEF40.77 (0.66-0.88)Acceptable
Mikolasevic et al[35]179NAFLDVCTE≥ F30.98Excellent
F40.98Excellent
Roccarina et al[40]671NAFLDVCTEF > 10.792 (0.60-0.91)Acceptable
F > 20.849 (0.78-0.91)Good
F > 30.851 (0.79-0.91)Good
F = 40.911 (0.83-0.96)Excellent
Zougmoréet al[55]476CLDVCTE≥ F20.86 (0.81-0.91)Good
≥ F30.89 (0.85-0.93)Good
≥ F40.90 (0.86-0.94)Good
Table 9 Diagnostic efficacy of other sound touch elastography techniques (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Ogino et al[37]107NAFLDS-mapF20.75Acceptable
F30.80Acceptable
F40.85Good
Gatos et al[27]152CLDSTEF ≥ F10.9683Excellent
F ≥ F20.9834Excellent
F ≥ F30.9763Excellent
F = F40.9509Excellent
Wang et al[48]524CHBSTEF > 40.87Good
F > 20.76Acceptable
Yang et al[51]102AILDSTEF20.82 (0.73-0.89)Good
F30.87 (0.78-0.93)Good
F40.91 (0.83-0.96)Excellent
Yang et al[50]106CLDSTEF0 vs F1-30.92Excellent
F0-1 vs F2-40.84Good
F0-2 vs F3-40.77Acceptable
F0-3 vs F40.71Acceptable
Wang et al[49]210HCCSWD≥ F20.857 (0.784-0.920)Good
≥ F30.815 (0.757-0.874)Good
F40.791 (0.730-0.852)Acceptable
Table 10 Diagnostic efficacy of sound touch elastography and related techniques (area under the receiver operating characteristic curves for fibrosis detection)
Ref.
Number of patients
Disease/diagnose
Diagnostic method
Fibrosis stage
AUROC (CI)
Assessment
Gatos et al[27]152CLDViTEF ≥ F10.9481Excellent
F ≥ F20.9698Excellent
F ≥ F30.9846Excellent
F = F40.9524Excellent
Yang et al[50]106CLDViTEF0 vs F1-30.88Good
F0-1 vs F2-40.84Good
F0-2 vs F3-40.80Acceptable
F0-3 vs F40.80Acceptable
Yu et al[62]85T2DMFibroTouch≥ F20.76 (0.66-0.86)Acceptable
≥ F30.81 (0.71-0.91)Good
≥ F40.92 (0.85-1.00Excellent
Qu et al[60]237NAFLDFibroTouch≥ F20.71Acceptable
≥ F30.71Acceptable
F40.77Acceptable
Table 11 Diagnostic efficacy of ultrasound techniques (area under the receiver operating characteristic curves for steatosis detection)
Ref.
Number of patients
Disease
Diagnostic method
Steatosis stage
AUROC (CI)
Assessment
Nogami et al[36]163NAFLDVCTE (CAP)≥ S10.89 (0.73-0.95)Good
S20.77 (0.82-0.82)Acceptable
S30.69 (0.75-0.75)Unacceptable
Liu et al[59]100NAFLDATIS ≥ 10.762Acceptable
S ≥ 20.774Acceptable
S ≥ 30.784Acceptable
SWES ≥ 10.764Acceptable
S ≥ 20.783Acceptable
S ≥ 30.802Good
Qu et al[60]237NAFLDUAPS10.88Good
S20.93Excellent
S30.88Good
Zhao et al[65]34MAFLDNLVS ≥ 10.875 (0.716-0.963)Good
S ≥ 20.735 (0.556-0.871)Acceptable
S ≥ 30.583 (0.402-0.749)Unacceptable
NLV-SDS ≥ 10.900 (0.748-0.976)Good
S ≥ 20.745 (0.567-0.878)Acceptable
S ≥ 30.603 (0.422-0.766)Unacceptable
Kjaergaard et al[57]137ALD/NAFLDB-mode ratioS ≥ 10.79 (0.70-0.88)Acceptable
S ≥ 20.76 (0.66-0.85)Acceptable
S ≥ 30.74 (0.62-0.86)Acceptable
Zhou et al[64]139NAFLD2D-SWESteatohepatitis0.88Good
Yazdani et al[61]49NAFLDSWAS0 vs ≥ S10.99Excellent
≤ S1 vs ≥ S20.98Excellent
≤ S2 vs S30.93Excellent
Yu et al[62]85MAFLDCAP (FibroTouch)S ≥ S10.84 (0.67-1.01)Good
S ≥ S20.88 (0.81-0.95)Good
S = S30.89 (0.82-0.95)Good
Hsu et al[56]28CLDATIS ≥ 10.97 (0.83-1.00)Acceptable
S ≥ 20.99 (0.86-1.00)Acceptable
S = 30.97 (0.82-1.00)Acceptable
Kim et al[67]60NASHHRI≥ S20.871 (0.783-0.956)Good
≥ S30.851 (0.735-0.930)Good
Kuroda et al[58]202NAFLD2D-SWE + UGAP≥ S10.89 (P < 0.05)Good
≥ S20.91 (P < 0.05)Excellent
S30.92 (P < 0.05)Excellent
Welman et al[63]76Not specified or mixedATIS1-S30.85 (0.75-0.91)Good
S2-S30.91 (0.83-0.99)Excellent
S0-S1 vs
S2-S3
0.89 (0.65-0.98)Good
Table 12 QUADAS-2 evaluation results
Ref.
Risk of bias by domain
Applicability by domain
D1
D2
D3
D4
D1
D2
D3
Aksakal et al[20]LowLowLowLowLowLowLow
Alcantara-Diaz et al[21]HighUncertainUncertainLowHighLowLow
Atzori et al[22]LowLowLowLowLowLowLow
Cassinotto et al[23]LowLowLowLowLowLowLow
Damjanovska et al[24]HighUncertainUncertainHighLowLowLow
Fang et al[25]LowUncertainUncertainLowLowLowLow
Garcovich et al[26]LowLowLowLowLowLowLow
Gatos et al[27]LowLowLowLowLowLowLow
Hsu et al[56]LowLowLowLowLowLowLow
Imajo et al[66]LowLowLowLowLowLowLow
Jocius et al[28]LowUncertainUncertainLowLowLowLow
Kavak et al[29]UncertainUncertainUncertainUncertainLowLowLow
Kim et al[67]LowLowLowLowLowLowLow
Kjaergaard et al[57]LowLowLowLowLowLowLow
Kuroda et al[58]LowLowLowLowLowLowLow
Laroia et al[30]LowLowLowLowLowLowLow
Lee et al[31]LowLowLowLowLowLowLow
Liu et al[59]LowUncertainUncertainLowLowLowLow
Manesis et al[32]UncertainUncertainUncertainLowLowLowLow
Martonik et al[33]LowLowLowLowLowLowLow
Mendoza et al[34]LowUncertainUncertainLowLowLowLow
Mikolasevic et al[35]LowUncertainUncertainLowLowLowLow
Nogami et al[36]UncertainLowLowLowLowLowLow
Ogino et al[37]LowLowLowUncertainLowLowLow
Paisant et al[38]LowLowLowLowLowLowLow
Patidar et al[39]LowLowLowUncertainLowLowLow
Prieto Ortiz et al[68]HighUncertainUncertainHighHighHighHigh
Qu et al[60]LowLowLowLowLowLowLow
Roccarina et al[40]LowLowLowLowLowLowLow
Saadi et al[41]LowLowLowLowLowLowLow
Seyrek et al[42]LowLowLowLowLowLowLow
Sharpton et al[43]LowLowLowLowLowLowLow
Soh et al[44]LowUncertainUncertainLowLowLowLow
Song et al[45]LowLowLowLowLowLowLow
Taibbi et al[46]HighLowLowHighLowLowLow
Wang et al[47]HighUncertainUncertainLowLowLowLow
Wang et al[48]UncertainLowLowUncertainLowLowLow
Wang et al[49]LowLowLowLowLowLowLow
Welman et al[63]HighLowLowHighLowLowLow
Yamaoka et al[54]LowLowLowLowLowLowLow
Yan et al[69]LowLowLowLowLowLowLow
Yang et al[50]HighLowLowUncertainLowLowLow
Yang et al[51]HighLowLowUncertainLowLowLow
Yazdani et al[61]LowLowLowLowLowLowLow
Yoo et al[53]HighLowLowUncertainLowLowLow
Yoo et al[52]HighLowLowUncertainLowLowLow
Yu et al[62]LowLowLowLowLowLowLow
Zhang et al[70]LowLowLowLowLowLowLow
Zhao et al[65]LowLowLowLowLowLowLow
Zhou et al[64]LowLowLowLowLowLowLow
Zougmoré et al[55]HighLowLowLowLowLowLow