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

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.

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

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.38.3.5142 ◽

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.

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Editorial on “Diagnostic Efficacy of Contrast‐Enhanced MRI in Detecting Residual or Recurrent Hepatocellular Carcinoma After Transarterial Chemoembolization: A Systematic Review and Meta‐analysis”

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.26989 ◽

2019 ◽

Vol 52 (4) ◽

pp. 1029-1030

Author(s):

D. Blair Macdonald ◽

Cynthia B. Walsh ◽

Matthew D.F. McInnes

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Transarterial Chemoembolization ◽

Meta Analysis ◽

Diagnostic Efficacy ◽

Recurrent Hepatocellular Carcinoma ◽

Enhanced Mri ◽

Contrast Enhanced ◽

Contrast Enhanced Mri

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Differentiating between hepatocellular carcinoma and intrahepatic cholangiocarcinoma using contrast-enhanced MRI features: a systematic review and meta-analysis

Clinical Radiology ◽

10.1016/j.crad.2018.12.016 ◽

2019 ◽

Vol 74 (5) ◽

pp. 406.e9-406.e18 ◽

Cited By ~ 2

Author(s):

M.-W. You ◽

S.J. Yun

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Intrahepatic Cholangiocarcinoma ◽

Meta Analysis ◽

Enhanced Mri ◽

Mri Features ◽

Contrast Enhanced ◽

Contrast Enhanced Mri

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Meta-Analysis of Quantitative Dynamic Contrast-Enhanced MRI for the Assessment of Neoadjuvant Chemotherapy in Breast Cancer

The American Surgeon ◽

10.1177/000313481908500630 ◽

2019 ◽

Vol 85 (6) ◽

pp. 645-653 ◽

Cited By ~ 2

Author(s):

Wei Jun ◽

Wang Cong ◽

Xie Xianxin ◽

Jiang Daqing

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Sensitivity And Specificity ◽

Meta Analysis ◽

High Sensitivity ◽

Cochrane Library ◽

Operating Characteristics ◽

Dce Mri ◽

Dynamic Contrast Enhanced ◽

Contrast Enhanced

The purpose of this meta-analysis was to determine the value of quantitative dynamic contrast-enhanced (DCE) MRI (DCE-MRI) in evaluating the response of breast cancer to neoadjuvant chemotherapy (NAC). PubMed, Embase, and Cochrane Library databases (from building to July 31, 2018) were searched to collect articles about the therapeutic evaluation of NAC using the quantitative DCE-MRI in patients with breast cancer. The sensitivities and specificities of quantitative DCE-MRI in the evaluation of NAC for breast cancer were extracted from the articles. Meta-DiSc1.4 was applied to evaluate the efficacy of the sensitivity and specificity; forest figure and summary receiver operating characteristics (SROC) were created. A total of 356 articles were enrolled in this study, including 739 cases in total, in which 218 cases were effective and the other 521 cases were ineffective to NAC, considering the pathological results as the gold standard. The sensitivity and specificity in the included 14 articles of quantitative DCE-MRI ( Ktrans, kep, and ve) in comprehensively evaluating NAC for breast cancer were 84 per cent (95% confidence interval (CI): 78–88%) and 83 per cent (95% CI: 79–86%), respectively. The area under SROC was 0.899 (95% CI: 0.867–0.943). The sensitivity and specificity in the three articles of Ktrans evaluating NAC for breast cancer were 84.1 per cent (95% CI: 71.0–92.1%) and 81.3 per cent (95% CI: 70.5%-88.5%), respectively. The area under SROC was 0.899 (95% CI: 0.834–0.962). Our study confirmed that the quantitative DCE-MRI is able to monitor NAC treatment for breast cancer because of its high sensitivity and specificity. However, there is a high degree of heterogeneity in published studies, highlighting the lack of standardization in the field.

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