Table 4.
Diagnostic performance of 2D MRE, 3D MRE, and serum fibrosis biomarkers for detecting liver fibrosis stage
| Cutoff value | AUC (95% CI) | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) | |
|---|---|---|---|---|---|---|
| Cirrhosis (F4) | ||||||
| 3D liver stiffness in kPa | 3.64 | 0.93 (0.90–0.96) | 79.4 (69.4–86.8) | 90.6 (85.4–94.1) | 79.4 (69.4–86.8) | 90.6 (85.4–94.1) |
| 2D liver stiffness in kPa | 3.67 | 0.92 (0.89–0.95) | 94.6 (87.2–98.0) | 75.1 (68.5–80.8) | 63.5 (54.8–71.4) | 96.8 (92.3–98.8) |
| APRI | 0.21 | 0.70*** (0.64–0.76) | 82.6 (73.0–89.4) | 51.7 (44.6–58.8) | 43.9 (36.5–51.7) | 86.7 (79.0–92.0) |
| FIB-4 | 1.60 | 0.82*** (0.77–0.86) | 85.9 (76.7–92.0) | 65.2 (58.1–71.7) | 53.0 (44.7–61.2) | 91.0 (84.8–94.9) |
| Forns index | 9.00 | 0.85*** (0.80–0.90) | 77.2 (67.0–85.0) | 84.1 (78.1–88.7) | 68.9 (59.0–77.5) | 89.0 (83.4–92.9) |
| Advanced fibrosis (≥ F3) | ||||||
| 3D liver stiffness in kPa | 3.15 | 0.95 (0.92–0.97) | 82.8 (75.8–88.2) | 97.8 (93.2–99.4) | 97.7 (93.1–99.4) | 83.1 (76.2–88.4) |
| 2D liver stiffness in kPa | 3.64 | 0.94 (0.92–0.97) | 85.4 (78.6–90.3) | 94.9 (89.3–97.7) | 95.0 (89.7–97.8) | 84.9 (78.0–90.0) |
| APRI | 0.21 | 0.71*** (0.65–0.77) | 74.5 (66.8–81.0) | 58.8 (50.1–67.1) | 67.6 (60.0–74.4) | 66.7 (57.4–74.9) |
| FIB-4 | 1.60 | 0.81*** (0.76–0.86) | 73.9 (66.2–80.4) | 75.7 (67.5–82.5) | 77.9 (70.2–84.1) | 71.5 (63.3–73.6) |
| Forns index | 9.00 | 0.80*** (0.75–0.85) | 58.0 (49.8–65.7) | 91.2 (84.8–95.2) | 88.4 (80.2–93.6) | 65.3 (58.0–71.9) |
| Significant fibrosis (≥ F2) | ||||||
| 3D liver stiffness in kPa | 2.65 | 0.92 (0.89–0.95) | 81.9 (76.0–86.7) | 94.8 (86.5–98.3) | 97.8 (94.1–99.3) | 65.2 (55.5–73.8) |
| 2D liver stiffness in kPa | 3.25 | 0.91 (0.88–0.94) | 77.3 (71.0–82.6) | 96.1 (88.3–99.0) | 98.2 (94.5–99.5) | 60.2 (50.9–68.8) |
| APRI | 0.47 | 0.66*** (0.59–0.73) | 30.6 (24.6–37.2) | 94.8 (86.5–98.3) | 94.3 (85.3–98.2) | 32.7 (26.7–39.4) |
| FIB-4 | 1.24 | 0.83** (0.78–0.88) | 79.6 (73.5–84.7) | 72.7 (61.2–82.0) | 89.1 (83.6–93.0) | 56.0 (45.7–65.8) |
| Forns index | 8.14 | 0.84** (0.79–0.89) | 63.9 (57.1–70.2) | 85.7 (75.5–92.3) | 92.6 (86.9–96.1) | 45.8 (37.6–54.3) |
| Any fibrosis (≥ F1) | ||||||
| 3D liver stiffness in kPa | 2.54 | 0.89 (0.84–0.94) | 74.9 (69.2–79.9) | 95.5 (75.1–99.8) | 99.5 (96.9–100.0) | 23.6 (15.5–34.0) |
| 2D liver stiffness in kPa | 2.99 | 0.89 (0.84–0.93) | 73.1 (67.3–78.2) | 100.0 (81.5–100.0) | 100.0 (97.6–100.0) | 23.2 (15.4–33.2) |
| APRI | 0.27 | 0.61*** (0.49–0.72) | 50.2 (44.1–56.3) | 72.7 (49.6–88.4) | 95.8 (90.6–98.3) | 10.6 (6.4–16.9) |
| FIB-4 | 0.85 | 0.83 (0.75–0.90) | 84.5 (79.5–88.5) | 68.2 (45.1–85.3) | 97.0 (93.7–98.7) | 26.3 (15.9–39.9) |
| Forns index | 8.46 | 0.80* (0.72–0.88) | 49.1 (43.0–55.2) | 100.0 (81.5–100.0) | 100.0 (96.5–100.0) | 13.8 (9.0–20.3) |
Significant difference between MRE methods and serum fibrosis biomarkers.
*
p < 0.05;
**
p < 0.01;
***
p < 0.001
MRE, magnetic resonance elastography; APRI, aspartate transaminase-to-platelet ratio index; FIB-4, fibrosis index based on four factors; AUC, area under the curve; PPV, positive predictive value; NPV, negative predictive value