Abstract
BACKGROUND: Shear wave elastography (SWE) is an emerging noninvasive imaging technique for assessing liver fibrosis. This meta-analysis aimed to evaluate the diagnostic accuracy of SWE compared to conventional imaging techniques. METHODS: A systematic search was conducted in PubMed, Embase, Cochrane Library, and Web of Science databases. Nine studies were included, and diagnostic performance metrics, including sensitivity, specificity, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC), were pooled using meta-analysis. Publication bias was assessed using Deeks' funnel plot asymmetry test. RESULTS: The pooled sensitivity and specificity of SWE were 0.88 (95% CI: 0.83-0.92) and 0.88 (95% CI: 0.83-0.91), respectively. The positive likelihood ratio (PLR) was 7.07 (95% CI: 5.26-9.50), and the negative likelihood ratio (NLR) was 0.14 (95% CI: 0.09-0.20). The DOR was 51.85 (95% CI: 29.80-90.19), and the area under the SROC curve (AUC) was 0.94 (95% CI: 0.91-0.96), indicating excellent diagnostic accuracy. Fagan nomogram analysis further confirmed SWE's clinical utility by significantly improving post-test probability. No significant publication bias was detected (p = 0.26). CONCLUSION: SWE is a highly accurate and reliable tool for diagnosing liver fibrosis, demonstrating superior diagnostic performance compared to conventional imaging techniques. SWE has significant potential to serve as a noninvasive alternative to liver biopsy in the clinical assessment of liver fibrosis.