Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

Abstract. Background: The aim of this meta-analysis was to evaluate the diagnostic accuracy of magnetic resonance angiography (MRA) for acute pulmonary embolism (PE). Methods: A systematic literature search was conducted that included studies from January 2000 to August 2015 using the electronic databases PubMed, Embase and Springer link. The summary receiver operating characteristic (SROC) curve, sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) as well as the 95 % confidence intervals (CIs) were calculated to evaluate the diagnostic accuracy of MRA for acute PE. Meta-disc software version 1.4 was used to analyze the data. Results: Five studies were included in this meta-analysis. The pooled sensitivity (86 %, 95 % CI: 81 % to 90 %) and specificity (99 %, 95 % CI: 98 % to 100 %) demonstrated that MRA diagnosis had limited sensitivity and high specificity in the detection of acute PE. The pooled estimate of PLR (41.64, 95 % CI: 17.97 to 96.48) and NLR (0.17, 95 % CI: 0.11 to 0.27) provided evidence for the low missed diagnosis and misdiagnosis rates of MRA for acute PE. The high diagnostic accuracy of MRA for acute PE was demonstrated by the overall DOR (456.51, 95 % CI: 178.38 - 1168.31) and SROC curves (AUC = 0.9902 ± 0.0061). Conclusions: MRA can be used for the diagnosis of acute PE. However, due to limited sensitivity, MRA cannot be used as a stand-alone test to exclude acute PE.

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Magnetic resonance angiography for the diagnosis of acute pulmonary embolism

Pulmonary Embolism ◽

10.1002/9781119039112.ch98 ◽

2016 ◽

pp. 490-498

Keyword(s):

Pulmonary Embolism ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Acute Pulmonary Embolism

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Diagnostic Accuracy of Dual-Energy CT in Detection of Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis

Canadian Association of Radiologists Journal ◽

10.1177/0846537120902062 ◽

2020 ◽

pp. 084653712090206 ◽

Cited By ~ 1

Author(s):

Waleed Abdellatif ◽

Mahmoud Ahmed Ebada ◽

Souad Alkanj ◽

Ahmed Negida ◽

Nicolas Murray ◽

...

Keyword(s):

Computed Tomography ◽

Systematic Review ◽

Pulmonary Embolism ◽

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Acute Pulmonary Embolism ◽

Meta Analysis ◽

Dual Energy ◽

Dual Energy Computed Tomography ◽

Sensitivity Specificity

Purpose: In this systematic review and meta-analysis, we aimed to investigate the accuracy of dual-energy computed tomography (DECT) in the detection of acute pulmonary embolism (PE). Methods: We searched Medline (via PubMed), EBSCO, Web of Science, Scopus, and the Cochrane Library for relevant published studies. We selected studies assessing the accuracy of DECT in the detection of PE. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies-2 tool. Meta-analysis was performed to calculate mean estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR). The summary receiver operating characteristic (sROC) curve was drawn to get the Cochran Q-index and the area under the curve (AUC). Results: Seven studies were included in our systematic review. Of the 182 patients included, 108 patients had PEs. The pooled analysis showed an overall sensitivity and specificity of 88.9% (95% confidence interval [CI]: 81.4%-94.1%) and 94.6% (95% CI: 86.7%-98.5%), respectively. The pooled PLR was 8.186 (95% CI: 3.726-17.986), while the pooled NLR was 0.159 (95% CI: 0.093-0.270). Cochran-Q was 0.8712, and AUC was 0.935 in the sROC curve. Conclusion: Dual-energy computed tomography shows high sensitivity, specificity, and diagnostic accuracy in the detection of acute PE. The high PLR highlights the high clinical importance of DECT as a prevalence-independent, rule-in test. Studies with a larger sample size with standardized reference tests are still needed to increase the statistical power of the study and support these findings.

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Diagnostic accuracy of magnetic resonance imaging in patients with suspected pulmonary embolism: A bivariate meta-analysis

Thrombosis Research ◽

10.1016/j.thromres.2017.03.027 ◽

2017 ◽

Vol 154 ◽

pp. 64-72 ◽

Cited By ~ 4

Author(s):

Alessandro Squizzato ◽

Fulvio Pomero ◽

Attilio Allione ◽

Roberto Priotto ◽

Nicoletta Riva ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Pulmonary Embolism ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Resonance Imaging ◽

Suspected Pulmonary Embolism

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Detection of Pelvic Vein Thrombosis by Magnetic Resonance Angiography in Patients With Acute Pulmonary Embolism and Normal Lower Limb Compression Ultrasonography

CHEST Journal ◽

10.1378/chest.122.1.115 ◽

2002 ◽

Vol 122 (1) ◽

pp. 115-121 ◽

Cited By ~ 43

Author(s):

Jean-Baptiste Stern ◽

Marc Abehsera ◽

Dominique Grenet ◽

Sylvie Friard ◽

Louis-Jean Couderc ◽

...

Keyword(s):

Pulmonary Embolism ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Lower Limb ◽

Acute Pulmonary Embolism ◽

Pelvic Vein ◽

Vein Thrombosis ◽

Compression Ultrasonography ◽

Limb Compression

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Gadolinium-Enhanced Magnetic Resonance Angiography for Detection of Acute Pulmonary Embolism

CHEST Journal ◽

10.1016/s0012-3692(15)31694-9 ◽

2003 ◽

Vol 124 (6) ◽

pp. 2324-2328 ◽

Cited By ~ 16

Author(s):

Paul D. Stein ◽

Pamela K. Woodard ◽

Russell D. Hull ◽

Fadi Kayali ◽

John G. Weg ◽

...

Keyword(s):

Pulmonary Embolism ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Acute Pulmonary Embolism

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Sensitivity and Specificity of Dickkopf-1 Protein in Serum for Diagnosing Hepatocellular Carcinoma: A Meta-Analysis

The International Journal of Biological Markers ◽

10.5301/jbm.5000101 ◽

2014 ◽

Vol 29 (4) ◽

pp. 403-410 ◽

Cited By ~ 8

Author(s):

Jie Zhang ◽

Ying Zhao ◽

Qin Yang

Keyword(s):

Hepatocellular Carcinoma ◽

Diagnostic Accuracy ◽

Test Performance ◽

Meta Analysis ◽

Diagnostic Odds Ratio ◽

Likelihood Ratios ◽

Summary Receiver Operating Characteristic ◽

Knowledge Infrastructure ◽

Combined Test ◽

Dickkopf 1

Objective This meta-analysis evaluated the diagnostic accuracy of positive serum Dickkopf-1 (DKK1) for diagnosing hepatocellular carcinoma (HCC). Material and methods Articles listed on Embase, PubMed, Wanfang, Weipu Periodical Database or the Chinese National Knowledge Infrastructure (CNKI) and published up to July 10, 2013, were searched in either English or Chinese. The pooled sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR) and summary receiver operating characteristic (sROC) curve were calculated to summarize the overall test performance. Results Four articles (6 studies) provided DKK1 diagnostic data. The pooled SEN, SPE, PLR, NLR, DOR and area under the sROC curve of DKK1 for the diagnosis of HCC were 0.65 (95% confidence interval [95% CI], 0.52-0.76), 0.94 (95% CI, 0.82-0.98), 10.1 (95% CI, 3.68-27.74), 0.38 (95% CI, 0.28-0.51), 26.90 (95% CI, 10.45-69.19) and 0.84 (95% CI, 0.81-0.87), respectively. Three articles (5 studies) provided DKK1 and α-fetoprotein (AFP) combined test data. The pooled SEN, SPE, PLR, NLR, DOR and area under the sROC curve of combined detection for the diagnosis of HCC were 0.81 (95% CI, 0.76-0.85), 0.85 (95% CI, 0.78-0.91), 5.52 (95% CI, 3.76-8.10), 0.22 (95% CI, 0.19-0.27), 24.60 (95% CI, 17.69-34.19) and 0.88 (95% CI, 0.85-0.91), respectively. Conclusion Both DKK1 and DKK1 plus AFP had high diagnostic accuracy for diagnosis of HCC.

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