scholarly journals Accuracy of Non-Contrast MRI for the Detection of Hepatocellular Carcinoma: A systematic review and meta-analysis

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Liping Lu ◽  
Xuming Pan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
High Sensitivity ◽  
Chronic Viral Hepatitis ◽  
Significant Heterogeneity ◽  
Chi Square ◽  
Creative Commons

Non-contrast MRI is used for identifying patients with hepatocellular carcinoma (HCC), especially among high-risk patients with cirrhosis or chronic viral hepatitis. The accuracy of non-contrast MRI has been investigated with varying results. We performed this meta-analysis to consolidate the evidence on the accuracy of non-contrast MRI for the detection of HCC. We conducted a systematic search in the databases of PubMed Central, SCOPUS, MEDLINE, EMBASE and Cochrane from inception till November 2020. We used the STATA software “Midas” package for meta-analysis. We included 15 studies with 3,756 patients. The pooled sensitivity and specificity of non-contrast MRI for HCC detection were 84% (95%CI, 78%-88%) and 94% (95%CI, 91%-97%). The positive likelihood ratio was 14.9 (95% CI, 9.0-24.7) and the negative one 0.17 (0.12-0.23). The overall quality of the studies was high. We found significant heterogeneity based on chi-square test results and I2 statistic > 75%. Deek’s test showed the absence of publication bias. We found that non-contrast MRI has high sensitivity and specificity as a tool for detecting HCC. Studies exploring its accuracy in different ethnic populations are required to strengthen the evidence. doi: https://doi.org/10.12669/pjms.38.3.5142 How to cite this:Lu L, Pan X. Accuracy of Non-Contrast MRI for the Detection of Hepatocellular Carcinoma: A systematic review and meta-analysis. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5142 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Accuracy of Various Forms of Contrast-Enhanced MRI for Diagnosing Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Chun Zhao ◽  
Hongyan Dai ◽  
Juwei Shao ◽  
Qian He ◽  
Wei Su ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Chi Square ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri

BackgroundContrast-enhanced MRI can be used to identify patients with hepatocellular carcinoma (HCC). However, studies around the world have found differing diagnostic accuracies for the technique. Hence, we designed this meta-analysis to assess the accuracy of contrast-enhanced MRI for HCC diagnosis.MethodsWe conducted a systematic search for all studies reporting the diagnostic accuracy of contrast-enhanced MRI for HCC in the databases of MEDLINE, EMBASE, Cochrane Library, Web of Science, SCOPUS, ScienceDirect, and Google Scholar from inception until January 2021. We used the “Midas” package from the STATA software to perform the meta-analysis.ResultsOur study was based on 21 publications with 5,361 patients. The pooled HCC diagnosis sensitivity and specificity were 75% (95% CI, 70%–80%) and 90% (95% CI, 88%–92%), respectively, for gadoxetic acid-enhanced MRI; and they were 70% (95% CI, 57%–81%) and 94% (95% CI, 85%–97%), respectively, for MRI with extracellular contrast agents (ECA-MRI). We found significant heterogeneity with a significant chi-square test and an I2 statistic >75%. We also found significant publication bias as per Deeks’ test results and funnel plot.ConclusionWe found that both types of contrast-enhanced MRI are accurate diagnostic and surveillance tools for HCC and offer high sensitivity and specificity. Further studies on different ethnic populations are required to strengthen our findings.

miR-224 is an early-stage biomarker of hepatocellular carcinoma with miR-224 and miR-125b as prognostic biomarkers

2020 ◽  
Vol 14 (15) ◽  
pp. 1485-1500
Author(s):  
Lichao Yang ◽  
Chunmeng Wei ◽  
Yasi Li ◽  
Xiao He ◽  
Min He
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Survival Analysis ◽  
Sensitivity And Specificity ◽  
Poor Prognosis ◽  
Early Stage ◽  
Meta Analysis ◽  
Benign Lesion ◽  
Diagnostic Efficiency ◽  
Low Expression

Aim: The aim was to systematically investigate the miRNA biomarkers for early diagnosis of hepatocellular carcinoma (HCC). Materials & methods: A systematic review and meta-analysis of miRNA expression in HCC were performed. Results: A total of 4903 cases from 30 original studies were comprehensively analyzed. The sensitivity and specificity of miR-224 in discriminating early-stage HCC patients from benign lesion patients were 0.868 and 0.792, which were superior to α-fetoprotein. Combined miR-224 with α-fetoprotein, the sensitivity and specificity were increased to 0.882 and 0.808. Prognostic survival analysis showed low expression of miR-125b and high expression of miR-224 were associated with poor prognosis. Conclusion: miR-224 had a prominent diagnostic efficiency in early-stage HCC, with miR-224 and miR-125b being valuable in the prognostic diagnosis.

scholarly journals Sitagliptin and Acute Pancreatitis: A Systematic Review and Meta-analysis

2021 ◽  
pp. 45-50
Author(s):  
Hyder Osman Mirghani ◽  
Salem Ahmed S. Shaman S. Shaman ◽  
Ibrahim Mahmoud Hussain Aljwah
Keyword(s):  
Systematic Review ◽  
Acute Pancreatitis ◽  
Meta Analysis ◽  
P Value ◽  
Significant Heterogeneity ◽  
Chi Square ◽  
Number Of Patients ◽  
The Usa ◽  
Peptidase Inhibitor ◽  
Relationship Of

Background and Objectives: Sitagliptin is a dipepidyl peptidase inhibitor (DPP-4i) with gentle antidiabetic effects with a lower risk of hypoglycemia. The association with acute pancreatitis is controversial. The current meta-analysis aimed to assess the relationship of sitagliptin and acute pancreatitis. Methods: The literature in PubMed and Google Scholar was searched for relevant articles published in the last ten years up to September 2021. The keywords sitagliptins, DPP-4i, acute pancreatitis were used with the protean AND or OR. Among the 204 articles retrieved, 24 full-texts were assessed for eligibility and only five studies (Three from the USA, one from Asia, and one from Canada) met the inclusion criteria for the systematic review. The author name, year of publication, country, type of study, number of patients, and the duration of the study were reported. Results: There were five studies. The total number of patients were 729808 with 6459 events. The studies showed no increased rate of acute pancreatitis following sitagliptin use, odd ratio, 0.79, 95% CI, 0.29-2.15, a significant heterogeneity was observer, I2 for heterogeneity=98%, P-value, <001, the P-value for overall effect was 0.65 and the chi-square, 160.15. Interpretation and Conclusion: Sitagliptin use is not associated with acute pancreatitis.

scholarly journals Diagnostic Accuracy of Confocal Laser Endomicroscopy for the Diagnosis of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12390
Author(s):  
Sneha Sethi ◽  
Xiangqun Ju ◽  
Richard M. Logan ◽  
Paul Sambrook ◽  
Robert A. McLaughlin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Squamous Cell Carcinoma ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Risk Of Bias ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Likelihood Ratios

Background: Advances in treatment approaches for patients with oral squamous cell carcinoma (OSCC) have been unsuccessful in preventing frequent recurrences and distant metastases, leading to a poor prognosis. Early detection and prevention enable an improved 5-year survival and better prognosis. Confocal Laser Endomicroscopy (CLE) is a non-invasive imaging instrument that could enable an earlier diagnosis and possibly help in reducing unnecessary invasive surgical procedures. Objective: To present an up to date systematic review and meta-analysis assessing the diagnostic accuracy of CLE in diagnosing OSCC. Materials and Methods. PubMed, Scopus, and Web of Science databases were explored up to 30 June 2021, to collect articles concerning the diagnosis of OSCC through CLE. Screening: data extraction and appraisal was done by two reviewers. The quality of the methodology followed by the studies included in this review was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A random effects model was used for the meta-analysis. Results: Six studies were included, leading to a total number of 361 lesions in 213 patients. The pooled sensitivity and specificity were 95% (95% CI, 92–97%; I2 = 77.5%) and 93% (95% CI, 90–95%; I2 = 68.6%); the pooled positive likelihood ratios and negative likelihood ratios were 10.85 (95% CI, 5.4–21.7; I2 = 55.9%) and 0.08 (95% CI, 0.03–0.2; I2 = 83.5%); and the pooled diagnostic odds ratio was 174.45 (95% CI, 34.51–881.69; I2 = 73.6%). Although risk of bias and heterogeneity is observed, this study validates that CLE may have a noteworthy clinical influence on the diagnosis of OSCC, through its high sensitivity and specificity. Conclusions: This review indicates an exceptionally high sensitivity and specificity of CLE for diagnosing OSCC. Whilst it is a promising diagnostic instrument, the limited number of existing studies and potential risk of bias of included studies does not allow us to draw firm conclusions. A conclusive inference can be drawn when more studies, possibly with homogeneous methodological approach, are performed.

Is jaw fractal dimension a reliable biomarker for osteoporosis screening? A systematic review and meta-analysis of diagnostic test accuracy studies

2021 ◽  
Author(s):  
Davi de Sá Cavalcante ◽  
Paulo Goberlânio de Barros Silva ◽  
Francisco Samuel Rodrigues Carvalho ◽  
Ana Rosa Pinto Quidute ◽  
Lúcio Mitsuo Kurita ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fractal Dimension ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Grey Literature ◽  
High Sensitivity ◽  
Total Sample ◽  
Control Group ◽  
Test Accuracy ◽  
Osteoporosis Screening

Objective: To summarize the evidence on the feasibility of maxillomandibular imaging exams-related fractal dimension (FD) in screening patients with osteoporosis. Methods: This registered systematic review followed the PRISMA-DTA statement. High sensitivity search strategies were developed for six primary databases and grey literature. QUADAS-2 items evaluated the risk of bias, and the GRADE approach assessed the evidence certainty. Results: From 1,034 records initially identified through database searching, four studies were included (total sample of 747 patients [osteoporosis, 136; control group, 611]). The meta-analysis showed that the overall sensitivity and specificity of the FD were 86.17 and 72.68%, respectively. In general, all studies showed low RoB and applicability concern. The certainty of the evidence was very low to moderate. Conclusions: This systematic review showed that the jaw-related FD presented sensitivity and specificity values higher than 70%, and its sensitivity in osteoporosis screening was a better parameter than specificity.

scholarly journals Role of chest MRI for the diagnosis of malignant pulmonary nodules: a systematic review and a meta-analysis

2021 ◽  
Vol 2 (3) ◽  
pp. 301-312
Author(s):  
Yuriy A. Vasilev ◽  
Olga Y. Panina ◽  
Evgeniia A. Grik ◽  
Kate S. Akhmad ◽  
Yulia N. Vasileva
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Pulmonary Nodules ◽  
Google Scholar ◽  
Significant Heterogeneity ◽  
Statistical Heterogeneity ◽  
Magnetic Resonance Imaging Mri

AIM: To evaluate the ability of magnetic resonance imaging (MRI) of the chest to detect malignant pulmonary nodules compared to compute tomography (CT). MATERIALS AND METHODS: We searched the following databases with the final date of search on April 7th, 2021: PubMed, Google Scholar. We selected studies according to the inclusion and exclusion criteria that assessed the detection of malignant lung nodules by MRI and CT and included information about sensitivity and specificity. Method of the analysis and data grouping was chosen with regard to statistical heterogeneity of the studies included in the analysis. We used the 2 test and I2 statistic to evaluate the heterogeneity. RESULTS: We selected 168 articles for the systematic review from the PubMed and Google Scholar databases. We included 21 studies on 1,188 patients in the meta-analysis and revealed statistically significant heterogeneity (р0,00001 for 2 test; I2=99%) for sensitivity and specificity. Hence, we used a random-effect model for further analysis. As a result, values of sensitivity for detection of pulmonary nodules with MRI of 70.4%100%, specificity ― from 60.6% to 100%. CONCLUSIONS: Thus, MRI has sufficient sensitivity and specificity for detecting malignant pulmonary nodules primarily discovered with CT.

scholarly journals MicroRNA-21 as a diagnostic marker for hepatocellular carcinoma: A systematic review and meta-analysis

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Juan Qu ◽  
Jizhi Yang ◽  
Ming Chen ◽  
Lihong Cui ◽  
Tianxi Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Diagnostic Marker ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Summary Receiver Operating Characteristic

Background: MicroRNA-21 (miR-21) is one of the oncogenic miRNAs which may be a potential diagnostic biomarker for hepatocellular carcinoma (HCC). Methods: We systematically searched Medline, Embase, the Cochrane Library, ISI Web of Knowledge, Scopus from inception to August 15, 2018, and reference lists of identified primary studies. Two independent investigators extracted patient and study characteristics. The sensitivity and specificity of microRNA-21 for HCC detection and were analyzed with a random effect model. The area under summary receiver operating characteristic curve (AUC) was used to estimate overall test performance. Results: A total of 515 HCC patients, and 338 healthy or chronic hepatitis controls from six published studies were enrolled in this meta-analysis. All articles were published in English with moderate-to-high quality. The overall pooled sensitivity and specificity were 85.2% (73.3% to 88.4%) and 79.2% (68.4% to 87.0%), respectively. The AUC area was 0.89 (95% CI: 0.85-0.91). The studies had moderate heterogeneity (I2=70.11%). None of the subgroups investigated-ethnicity, controls, sample source-could account for the heterogeneity. Conclusion: MiR-21 is a helpful biomarker for early diagnosis of HCC. Nevertheless, the results of the test must be interpreted carefully in the context of medical history, erological tests and imaging examinations for HCC surveillance. doi: https://doi.org/10.12669/pjms.35.5.685 How to cite this:Qu J, Yang J, Chen M, Cui L, Wang T, Gao W, et al. MicroRNA-21 as a diagnostic marker for hepatocellular carcinoma: A systematic review and meta-analysis. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.685 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction: a systematic review and meta-analysis

2013 ◽  
Vol 3 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Tatiana Raskovalova ◽  
Raphael Twerenbold ◽  
Paul O Collinson ◽  
Till Keller ◽  
Hélène Bouvaist ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Cardiac Troponin ◽  
Meta Analysis ◽  
Myocardial Necrosis ◽  
High Sensitivity ◽  
St Segment Elevation ◽  
Rule Out

Aims: This systematic review aimed to investigate the diagnostic accuracy of combined cardiac troponin (cTn) and copeptin assessment in comparison to cTn alone for early rule-out of acute myocardial infarction (AMI). Methods: Primary studies were eligible if they evaluated diagnostic accuracy for cTn with and without copeptin in patients with symptoms suggestive of AMI. AMI was defined according to the universal definition, using detection of cTn as a marker for myocardial necrosis. Eligible studies were identified by searching electronic databases (Medline, EMBASE, Science Citation Index Expanded, CINAHL, Pascal, and Cochrane) from inception to March 2013, reviewing conference proceedings and contacting field experts and the copeptin manufacturer. Results: In 15 studies totalling 8740 patients (prevalence of AMI 16%), adding copeptin improved the sensitivity of cTn assays (from 0.87 to 0.96, p=0.003) at the expense of lower specificity (from 0.84 to 0.56, p<0.001). In 12 studies providing data for 6988 patients without ST-segment elevation, the summary sensitivity and specificity estimates were 0.95 (95% CI 0.89 to 0.98) and 0.57 (95% CI 0.49 to 0.65) for the combined assessment of cTn and copeptin. When a high-sensitivity cTnT assay was used in combination with copeptin, the summary sensitivity and specificity estimates were 0.98 (95% CI 0.96 to 1.00) and 0.50 (95% CI 0.42 to 0.58). Conclusion: Despite substantial between-study heterogeneity, this meta-analysis demonstrates that copeptin significantly improves baseline cTn sensitivity. Management studies are needed to establish the effectiveness and safety of measuring copeptin in combination with high-sensitivity cTnT for early rule-out of AMI without serial testing.

scholarly journals A Systematic Review and Meta-Analysis of the Accuracy of in VivoReflectance Confocal Microscopy for the Diagnosis of Primary Basal Cell Carcinoma

2019 ◽  
Vol 8 (9) ◽  
pp. 1462 ◽  
Author(s):  
Lupu ◽  
Popa ◽  
Voiculescu ◽  
Caruntu ◽  
Caruntu
Keyword(s):  
Systematic Review ◽  
Confocal Microscopy ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Sensitivity And Specificity ◽  
Basal Cell ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Diagnostic Odds Ratio ◽  
Likelihood Ratios

Basal cell carcinoma (BCC) is the most common cancer worldwide and its incidence is constantly rising. Early diagnosis and treatment can significantly reduce patient morbidity and healthcare costs. The value of reflectance confocal microscopy (RCM) in non-melanoma skin cancer diagnosis is still under debate. This systematic review and meta-analysis were conducted to assess the diagnostic accuracy of RCM in primary BCC. PubMed, Google Scholar, Scopus, and Web of Science databases were searched up to July 05, 2019, to collect articles concerning primary BCC diagnosis through RCM. The studies’ methodological quality was assessed by the QUADAS-2 tool. The meta-analysis was conducted using Stata 13.0, RevMan 5.0, and MetaDisc 1.4 software. We included 15 studies totaling a number of 4163 lesions. The pooled sensitivity and specificity were 0.92 (95% CI, 0.87–0.95; I2= 85.27%) and 0.93 (95% CI, 0.85–0.97; I2= 94.61%), the pooled positive and negative likelihood ratios were 13.51 (95% CI, 5.8–31.37; I2= 91.01%) and 0.08 (95% CI, 0.05–0.14; I2= 84.83%), and the pooled diagnostic odds ratio was 160.31 (95% CI, 64.73–397.02; I2=71%). Despite the heterogeneity and risk of bias, this study demonstrates that RCM, through its high sensitivity and specificity, may have a significant clinical impact on the diagnosis of primary BCC.

scholarly journals Diagnostic Accuracy of Radiologic Methods for Ankle Syndesmosis Injury: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (7) ◽  
pp. 968 ◽  
Author(s):  
Chun ◽  
Cho ◽  
Min ◽  
Park ◽  
Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
High Sensitivity ◽  
X Rays ◽  
Syndesmosis Injury ◽  
Arthroscopic Findings ◽  
Similar Accuracy ◽  
Radiological Methods

: Misdiagnosis and inadequate treatment of syndesmosis could result in significant long-term morbidity including pain, instability, and degenerative changes of the ankle joint. The objective of this systematic review and meta-analysis was to determine whether radiologic tests accurately and reliably diagnose ankle syndesmosis injury. Medline, Embase, and Cochrane were searched. The database search resulted in 258 full text articles that we assessed for eligibility, we used eight studies that met all the inclusion criteria. In subgroup meta-analysis, the sensitivity analysis showed significant differences only in the MRI (Magnetic Resonance Imaging), and specificity was not statistically significant. In diagnostic meta-analysis, the pooled sensitivity and specificity were 0.528 and 0.984 for X-rays, 0.669 and 0.87 for CT (Computed Tomography), and 0.929 and 0.865 for MRI, all respectively. For sensitivity, MRI showed significantly sensitivity as higher than the other methods, and we detected no significance for specificity. Syndesmosis injuries differed significantly in the accuracy of radiological methods according to the presence of accompanied ankle fractures. In patients with fractures, simple radiography has good specificity, and CT and MRI have high sensitivity and specificity irrespective of fracture; in particular, MRI has similar accuracy to gold standard arthroscopic findings.

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