Accuracy of controlled attenuation parameter for liver steatosis in patients at risk for metabolic dysfunction-associated steatotic liver disease using magnetic resonance imaging: a systematic review and meta-analysis.

Autor:	Malandris K; Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Apostolos Tsapas)., Katsoula A; Second Propedeutic Medical Department, Aristotle University of Thessaloniki, Greece (Anastasia Katsoula, Olga Giouleme)., Liakos A; Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Apostolos Tsapas).; Second Medical Department, Aristotle University of Thessaloniki, Greece (Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Eleni Theocharidou)., Bekiari E; Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Apostolos Tsapas).; Second Medical Department, Aristotle University of Thessaloniki, Greece (Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Eleni Theocharidou)., Karagiannis T; Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Apostolos Tsapas).; Second Medical Department, Aristotle University of Thessaloniki, Greece (Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Eleni Theocharidou)., Theocharidou E; Second Medical Department, Aristotle University of Thessaloniki, Greece (Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Eleni Theocharidou)., Giouleme O; Second Propedeutic Medical Department, Aristotle University of Thessaloniki, Greece (Anastasia Katsoula, Olga Giouleme)., Sinakos E; Fourth Medical Department, Aristotle University of Thessaloniki, Greece (Emmanouil Sinakos)., Tsapas A; Clinical Research and Evidence-Based Medicine Unit, Aristotle University of Thessaloniki, Greece (Konstantinos Malandris, Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Apostolos Tsapas).; Second Medical Department, Aristotle University of Thessaloniki, Greece (Aris Liakos, Eleni Bekiari, Thomas Karagiannis, Eleni Theocharidou).; Harris Manchester College, University of Oxford, UK (Apostolos Tsapas).
Jazyk:	angličtina
Zdroj:	Annals of gastroenterology [Ann Gastroenterol] 2024 Sep-Oct; Vol. 37 (5), pp. 579-587. Date of Electronic Publication: 2024 Aug 19.
DOI:	10.20524/aog.2024.0910
Abstrakt:	Background: The controlled attenuation parameter (CAP) enables the noninvasive assessment of liver steatosis. We performed a systematic review and meta-analysis to evaluate the diagnostic accuracy of CAP for identifying liver steatosis in patients at risk for metabolic dysfunction-associated steatotic liver disease (MASLD), using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard. Methods: We searched Medline, Embase, Cochrane Library and gray literature sources up to March 2024. We defined MASLD as MRI-PDFF ≥5%. We also assessed the accuracy of CAP for identifying patients with MRI-PDFF ≥10%. We calculated pooled sensitivity and specificity estimates using hierarchical random-effects models. We assessed the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies 2 tool, and the certainty in meta-analysis estimates using the Grading of Recommendations Assessment, Development and Evaluation framework. Results: We included 8 studies with 1116 participants. The prevalence of MASLD ranged from 65.2-93.9%. Pooled sensitivity and specificity of CAP for MRI-PDFF ≥5% were 0.84 (95% confidence interval [CI] 0.79-0.88) and 0.77 (95%CI 0.68-0.84), respectively, with an area under the receiver operating characteristic curve (AUROC) of 0.88. The pooled sensitivity and specificity for MRI-PDFF ≥10% were 0.83 (95%CI 0.80-0.87) and 0.72 (95%CI 0.59-0.82), with an AUROC of 0.85. The certainty in our estimates was low to very low because of the high risk of bias, inconsistency and imprecision. Conclusions: CAP has acceptable diagnostic accuracy for both MRI-PDFF ≥5% and MRI-PDFF ≥10%. Adequately powered and rigorously conducted diagnostic accuracy studies are warranted to establish the optimal CAP thresholds. Competing Interests: Conflict of Interest: AT has received research support from Boehringer Ingelheim. EB and ES have received research support from Novo Nordisk. All other authors declare no conflicts of interest (Copyright: © 2024 Hellenic Society of Gastroenterology.)
Databáze:	MEDLINE
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