scholarly journals MRI Protocol for Pituitary Assessment in Children with Growth or Puberty Disorders—Is Gadolinium Contrast Administration Actually Needed?

2021 ◽  
Vol 10 (19) ◽  
pp. 4598
Author(s):  
Marta Michali-Stolarska ◽  
Andrzej Tukiendorf ◽  
Anna Zacharzewska-Gondek ◽  
Jagoda Jacków-Nowicka ◽  
Joanna Chrzanowska ◽  
...  
Keyword(s):  
Diagnostic Value ◽  
P Value ◽  
Gadolinium Contrast ◽  
Contrast Administration ◽  
Post Contrast ◽  
Mri Examination ◽  
Mri Protocol ◽  
Rathke's Cleft ◽  
Sensitivity Specificity ◽  
Waiting Children

The aim of this study was to assess the diagnostic value of non-contrast pituitary MRI in children with growth or puberty disorders (GPDs) and to determine the criteria indicating the necessity to perform post-contrast examination. A retrospective study included re-analysis of 567 contrast-enhanced pituitary MRIs of children treated in a tertiary reference center. Two sets of sequences were created from each MRI examination: Set 1, including common sequences without contrast administration, and Set 2, which included common pre- and post-contrast sequences (conventional MRI examination). The differences in the visibility of pituitary lesions between pairs of sets were statistically analyzed. The overall frequency of Rathke’s cleft cysts was 11.6%, ectopic posterior pituitary 3.5%, and microadenomas 0.9%. Lesions visible without contrast administration accounted for 85% of cases. Lesions not visible before and diagnosed only after contrast injection accounted for only 0.18% of all patients. Statistical analysis showed the advantage of the antero-posterior (AP) pituitary dimension over the other criteria in determining the appropriateness of using contrast in pituitary MRIs. The AP dimension was the most significant factor in logistic regression analysis: OR = 2.23, 95%CI, 1.35–3.71, p-value = 0.002, and in ROC analysis: AUC: 72.9% with a cut-off value of 7.5 mm, with sensitivity/specificity rates of 69.2%/73.5%. In most cases, the use of gadolinium-based contrast agent (GBCA) in pituitary MRI in children with GPD is unnecessary. The advantages of GBCA omission include shortening the time of MRI examination and of general anesthesia; saving time for other examinations, thus increasing the availability of MRI for waiting children; and acceleration in their further clinical management.

scholarly journals Contrast-free MRI Protocol for Pituitary Assessment in Children with Growth or Puberty Disorders: A Practical Approach.

2021 ◽  
Author(s):  
Marta Michali-Stolarska ◽  
Andrzej Tukiendorf ◽  
Jagoda Jacków-Nowicka ◽  
Anna Zacharzewska-Gondek ◽  
Joanna Chrzanowska ◽  
...  
Keyword(s):  
P Value ◽  
Contrast Administration ◽  
Post Contrast ◽  
Mri Examination ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Rathke's Cleft Cysts ◽  
Rathke's Cleft ◽  
Sensitivity Specificity ◽  
Administration Methods

Abstract Objectives Most of the pituitary MRI examinations in children with growth or puberty disorders (GPD) might not require gadolinium-based contrast agent (GBCA) administration. Methods Retrospective re-analysis of contrast-enhanced 567 pituitary MRIs of children with GPD. Two sets of sequences were created from each MRI examination: Set1 - common sequences without contrast administration and Set2 - common pre- and post-contrast sequences. The differences in the visibility of pituitary lesions between sets were statistically analyzed. Results The overall frequency of Rathke's cleft cysts was 11.6%, ectopic posterior pituitary 3.5% and microadenomas 0.9%. Lesions visible without contrast administration accounted for 85% of cases, while lesions diagnosed only after contrast injection accounted for 0.18% of all patients. Statistical analysis showed the advantage of antero-posterior (AP) pituitary dimension over other criteria in determining the appropriateness of using contrast in pituitary MRIs. The AP dimension was the most significant factor in logistic regression analysis: OR=2.23, 95%CI, 1.35-3.71, p-value=0.002 and in ROC analysis: AUC:72.9% with cut-off value 7.5 mm, with sensitivity/specificity rates: 69.2%/73.5%. Conclusions In most cases, the use of GBCA in pituitary MRI in children with GPD is unnecessary. The additional advantages of GBCA omission include: shortening the time of MRI examination and of general anesthesia.

scholarly journals Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

2021 ◽  
Vol 18 (7) ◽  
pp. 3598
Author(s):  
Vincenza Granata ◽  
Roberta Grassi ◽  
Roberta Fusco ◽  
Sergio Venanzio Setola ◽  
Andrea Belli ◽  
...  
Keyword(s):  
Treatment Response ◽  
Predictive Value ◽  
Random Order ◽  
P Value ◽  
Liver Imaging ◽  
Data Systems ◽  
Post Contrast ◽  
Conventional Mri ◽  
Mri Protocol ◽  
Mri Study

Background: Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of hepatocellular carcinoma (HCC) following loco regional therapy. The aim of this study was to compare sensitivity of standard MRI protocol versus abbreviated protocol (only T1-Weigthed fat suppressed (FS) sequences pre- and post-contrast phase) in the detection of ablated area according to LI-RADS Treatment Response (LR-TR) categories. Methods: From January 2015 to June 2020, we selected 64 patients with HCC, who underwent Radiofrequency ablation (RFA) or Microwave ablation (MWA) treatment. According to inclusion criteria, 136 pathologically proven treated HCC (median 2, range 1–3 per patient; mean size 20.0 mm; range 15–30 mm) in 58 patients (26 women, 32 men; median age, 74 years; range, 62–83 years) comprised our study population. For each ablated area, abbreviated protocol, and standard Magnetic Resonance Imaging (MRI) studies were independently and blindly assessed in random order within and between three expert radiologists. Each radiologist assessed the ablated area by using the following categories: “LR-TR Non-viable” = 1; “LR-TR Equivocal” = 2 and “LR-TR Viable” = 0. Results: According to the concordance between MRI and Contrast enhancement ultrasound (CEUS) among 136 treated HCCs, 115 lesions were assessed as non-viable or totally ablate and 21 as viable or partially ablate. The accuracy for standard MRI protocol and abbreviated MRI protocol for predicting pathologic tumor viability of a consensus reading was 98.6% (sensitivity = 100%; specificity = 98.3%; positive predictive value = 91.3% and negative predictive value = 100%). No differences were found in sensitivity or specificity between standard MRI LR-TR viable and abbreviated MRI LR-TR viable categories (p value > 0.05 at McNemar test). Conclusion: The abbreviated dynamic protocol showed similar diagnostic accuracy to conventional MRI study in the assessment of treated HCCs, with a reduction of the acquisition study time of 30% respect to conventional MRI.

scholarly journals Diagnostic value of DWI-MRI for the detection of acute plaques in the relapse phase of multiple sclerosis

2021 ◽  
Vol 20 (1) ◽  
pp. 35-40
Author(s):  
Mehran Yousefi ◽  
◽  
Mehdi Panahali ◽  
Kamran Azarkhish ◽  
Nazanin Azizi Shalbaf ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Predictive Value ◽  
Brain Mri ◽  
Diagnostic Value ◽  
Gadolinium Contrast ◽  
Mcdonald Criteria ◽  
Contrast Enhanced ◽  
Gadolinium Contrast Agents ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Background. The 2010 revision of the McDonald criteria, widely used for the diagnosis of multiple sclerosis (MS), has established that dissemination in time (DIT) can be demonstrated by the simultaneous presence of asymptomatic gadolinium-enhancing and non-enhancing plaques on a single magnetic resonance imaging (MRI). When the use of gadolinium contrast agents is contraindicated, diffusion-weighted imaging (DWI) is utilized to confirm diffusion alterations in active inflammatory plaques. This study intended to examine whether DWI can be a viable alternative to contrast-enhanced T1-weighted imaging for demonstrating DIT in MS. Material and methods.We assessed 30 previously diagnosed MS patients during acute relapse (based on the 2010 McDonald criteria) and evaluated their brain MRI via DWI‚ contrast-enhanced T1-weighted imaging, and FLAIR sequences. Asymptomatic plaques were defined as either hyperintense or non-hyperintense in DWI and enhancing or non-enhancing in T1GAD-MRI. Statistical indices for the prediction of plaque enhancement in T1 GAD-MRI via DWI-MRI were calculated and compared. Results. The 30 participants in our study had a total of 925 demyelinating plaques that were larger than 3mm in size and presented to be hyperintense in FLAIR-MRI. Diffusion hyperintensity and plaque enhancement were significantly correlated. The sensitivity‚ specificity, positive predictive value‚ negative predictive value, and accuracy of DWI were calculated to be 69.66%‚ 99.76%‚ 96.88%‚ 96.86%, and 96.86%, respectively. Conclusions. Hyperintense DWI findings do not necessarily overlap with contrast enhancements in T1 GAD-MRI. DWI was shown to produce a higher rate of false-positive results. Our study concludes that although T1 GAD-MRI should not be replaced by DWI to determine DIT due to its lower specificity, DWI’s continued use as a surrogate screening imaging sequence whenever the use of T1GAD-MRI is of concern is not without its merits.

scholarly journals Diagnostic value of gadolinium contrast administration for spinal cord magnetic resonance imaging in multiple sclerosis patients and correlative markers of lesion enhancement

2021 ◽  
Vol 7 (4) ◽  
pp. 205521732110479
Author(s):  
Kianush Karimian-Jazi ◽  
Ulf Neuberger ◽  
Katharina Schregel ◽  
Gianluca Brugnara ◽  
Martin Bendszus ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Gadolinium Contrast ◽  
Contrast Administration ◽  
Signal Ratio ◽  
Spine Magnetic Resonance Imaging

Background Magnetic resonance imaging is essential for monitoring people with multiple sclerosis, but the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging is unclear. Objective To assess the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging follow-up examinations and identify imaging markers correlating with lesion enhancement. Methods A total of 65 multiple sclerosis patients with at least 2 spinal magnetic resonance imaging follow-up examinations were included. Spine magnetic resonance imaging was performed at 3 Tesla with a standardized protocol (sagittal and axial T2-weighted turbo spin echo and T1-weighted post-contrast sequences). T2 lesion load and enhancing lesions were assessed by two independent neuroradiologists for lesion size, localization, and T2 signal ratio (T2 signallesion/T2 signalnormal appearing spinal cord). Results A total of 68 new spinal T2 lesions and 20 new contrast-enhancing lesions developed during follow-up. All enhancing lesions had a discernable correlate as a new T2 lesion. Lesion enhancement correlated with a higher T2 signal ratio compared to non-enhancing lesions (T2 signal ratio: 2.0 ± 0.4 vs. 1.4 ± 0.2, **** p < 0.001). Receiver operating characteristics analysis showed an optimal cutoff value of signal ratio 1.78 to predict lesion enhancement (82% sensitivity and 97% specificity). Conclusion Gadolinium contrast administration is dispensable in follow-up spine magnetic resonance imaging if no new T2 lesions are present. Probability of enhancement correlates with the T2 signal ratio.

Power Doppler Sonography Is a Promising Imaging Tool in the Diagnosis of Hemophilic Synovitis - Preliminary Analyses.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1010-1010 ◽  
Author(s):  
Suchitra S. Acharya ◽  
Robert Schloss ◽  
Jonathan Dyke ◽  
Akhil Narang ◽  
Douglas N. Mintz ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Power Doppler ◽  
Joint Damage ◽  
Joint Disease ◽  
P Value ◽  
Power Doppler Sonography ◽  
Gadolinium Contrast ◽  
Post Contrast ◽  
Imaging Tool ◽  
Perfusion Studies

Abstract Hemarthrosis, a common manifestation of hemophilia, results in synovial proliferation leading to the development of synovitis, followed by arthropathy. Selective strategies like prophylaxis or isotopic synovectomy (IS) could be applied to prevent imminent joint deterioration but these are expensive, and their timing is unclear. Conventionally, synovitis was diagnosed based on clinical examination and radiography, which together tend to underestimate the extent of joint damage. Currently, magnetic resonance imaging (MRI) is utilized for the evaluation of cartilage and synovium in hemophilic joint disease (HJD). However, the need for sedation in younger children and high costs preclude its utility especially when frequent monitoring may be needed for management decisions. More recently, Power Doppler sonography (PDS) has been utilized to both detect and quantitate alterations in vascular flow in other arthritides. In the current study we compared findings obtained on PDS(using a Elegra scanner with a 7.5 MHz linear phased array transducer in tissue harmonic mode) in 12 subjects with HJD to MRI (using 3.0T GE scanner with dynamic gadolinium contrast enhanced perfusion studies and gradient echo sequence) as a reference standard. Clinical Joint scores were determined as per the Petrini Scoring system. Radiological Joint scores were as follows: No synovitis (0), mild (1), moderate (2) and intense (3). Our preliminary analyses showed that MRI and PDS could detect increased vascularity of the synovium in all subjects with clinically active synovitis (6/12) and that Clinical Joint scores correlated with Synovitis scores on MRI and PDS. Further, synovial thickness, vascularity of synovium defined as enhancement on post-contrast MRI (MRI flow) and pixel count on PDS (PDS flow) correlated significantly between the two methods - Table 1. We previously observed that HJD subjects have significantly elevated levels of angiogenic markers such as vascular endothelial growth factor (VEGF) as compared to controls thus implicating VEGF as a serological marker for synovitis. Acknowledging the fact that PDS detects flow at the microvascular level we further observed that subjects with increased synovial vascularity showed significant positive correlations with VEGF levels - Table 1. Hence, our data suggest that PDS in children may be a promising and inexpensive imaging tool in diagnosing synovitis associated with HJD. It could be potentially used as a screening tool after one or two joint bleeds to monitor for the development of early synovitis and aid in tailoring prophylaxis. Based upon these preliminary analyses, correlation of data obtained from PDS with serological markers of angiogenesis may further aid in predicting joint disease activity. Comparison MRI PDS p-value * p-values &lt; 0.05 are significant as assessed by Spearman rank correlation coefficient; ** pce = post contrast enhancement; *** Synovial Thickness or VEGF Levels compared to indicated imaging technique Clinical Joint Score (Petrini) 1.54 (synovitis score) 0.01* Clinical Joint Score (Petrini) 1.46 (synovitis) 0.04* Mean Synovial Thickness (cm) 4.77 7.97 0.03* Flow (Vascularity) 138.10 (pce**) 9.22 (pixel count) 0.009* Mean Synovial Thickness vs. Flow *** 0.12 Mean Synovial Thickness vs. Flow *** 0.02* VEGF Levels vs. Flow *** 0.03* VEGF Levels vs. Flow *** 0.049*

scholarly journals Diagnostic value of polymerase chain reaction targeting insertion sequence IS1081 for the diagnosis of pediatric tuberculosis

2020 ◽  
Vol 7 (4) ◽  
pp. 905
Author(s):  
Shehraz Firoz ◽  
Sonia Bhatt
Keyword(s):  
Pulmonary Tuberculosis ◽  
Insertion Sequence ◽  
Diagnostic Value ◽  
P Value ◽  
Extra Pulmonary Tuberculosis ◽  
Extra Pulmonary ◽  
Mgit Culture ◽  
Pediatric Tuberculosis ◽  
Sensitivity Specificity ◽  
Pcr Targeting

Background: Aim of this study was to evaluate the efficacy of PCR targeting IS1081in diagnosis of pediatric tuberculosis and compare the results with MGIT culture.Methods: This prospective study was conducted in the department of pediatrics, S.N. medical college, Agra. 100 subjects (28 pulmonary 72 extra pulmonary) were registered in study. The specimens obtained from these cases were subjected to Ziehl–Neelsen staining (ZN), MGIT 960 TB culture and PCR targeting insertion sequence IS1081. Sensitivity, specificity, PPV and NPV of PCR were calculated in pulmonary and extra pulmonary specimens. The results of PCR IS1081 were compared to MGIT culture.Results: Microscopy with ZN staining was positive in 12 (12%) samples. MGIT culture was positive in 44% samples with maximum positivity in sputum (70%). PCR IS1081 has shown 93.3% sensitivity in pulmonary tuberculosis, while PCR IS1081 has shown 93.1% sensitivity in extra pulmonary tuberculosis.  In diagnosis of childhood tuberculosis PCR IS1081 was found to be statistically significant (p value <0.05) as compared with MGIT culture. Result was statistically significant (p value <0.05) in CSF samples only.Conclusions: The study concluded that the PCR targeting sequence IS1081 technique is the most sensitive technique for a quick identification of MTB in pulmonary and extra pulmonary tuberculosis.

scholarly journals Diagnostic value of [18F]FDG PET/MRI for staging in patients with ovarian cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hideaki Tsuyoshi ◽  
Tetsuya Tsujikawa ◽  
Shizuka Yamada ◽  
Hidehiko Okazawa ◽  
Yoshio Yoshida
Keyword(s):  
Ovarian Cancer ◽  
Fdg Pet ◽  
Diagnostic Value ◽  
Mri Contrast ◽  
Diagnostic Potential ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Imaging Results ◽  
N Stage ◽  
Sensitivity Specificity

Abstract Purpose To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) in ovarian cancer. Materials and methods Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis. Results Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95% CI 0.72–0.83) (p < 0.05). Accuracy for T status was 96.4% (95% CI 0.96–0.96) and 92.9% (95% CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95% CI 0.88–1.00) and 100% (95% CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95% CI 0.76–0.85) and 30.8% (95% CI 0.19–0.31) for ceCT and M staging representing significant differences (p < 0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95% CI 0.57–0.91), 95.7% (95% CI 0.93–0.97) and 93.9% (95% CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95% CI 0.24–0.58), 96.6% (95% CI 0.94–0.98) and 90.8% (95% CI 0.87–0.94) for ceCT. Conclusions [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.

scholarly journals Discovery and function exploration of microRNA-155 as a molecular biomarker for early detection of breast cancer

Breast Cancer ◽  
2021 ◽  
Author(s):  
Xuemin Liu ◽  
Qingyu Chang ◽  
Haiqiang Wang ◽  
Hairong Qian ◽  
Yikun Jiang
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Protein Interactions ◽  
Meta Analysis ◽  
Enrichment Analysis ◽  
Diagnostic Value ◽  
Diagnostic Biomarker ◽  
Analysis Model ◽  
Sensitivity Specificity ◽  
Function Enrichment

Abstract Background MicroRNA-155 (miR-155) may function as a diagnostic biomarker of breast cancer (BC). Nevertheless, the available evidence is controversial. Therefore, we performed this study to summarize the global predicting role of miR-155 for early detection of BC and preliminarily explore the functional roles of miR-155 in BC. Methods We first collected published studies and applied the bivariate meta-analysis model to generate the pooled diagnostic parameters of miR-155 in diagnosing BC such as sensitivity, specificity and area under curve (AUC). Then, we applied function enrichment and protein–protein interactions (PPI) analyses to explore the potential mechanisms of miR-155. Results A total of 21 studies were finally included. The results indicated that miR-155 allowed for the discrimination between BC patients and healthy controls with a sensitivity of 0.87 (95% CI 0.78–0.93), specificity of 0.82 (0.72–0.89), and AUC of 0.91 (0.88–0.93). In addition, the overall sensitivity, specificity and AUC for circulating miR-155 were 0.88 (0.76–0.95), 0.83 (0.72–0.90), and 0.92 (0.89–0.94), respectively. Function enrichment analysis revealed several vital ontologies terms and pathways associated with BC occurrence and development. Furthermore, in the PPI network, ten hub genes and two significant modules were identified to be involved in some important pathways associated with the pathogenesis of BC. Conclusions We demonstrated that miR-155 has great potential to facilitate accurate BC detection and may serve as a promising diagnostic biomarker for BC. However, well-designed cohort studies and biological experiments should be implemented to confirm the diagnostic value of miR-155 before it can be applied to routine clinical procedures.

scholarly journals Diagnostic Value of Whole-Body MRI Short Protocols in Bone Lesion Detection in Multiple Myeloma Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1053
Author(s):  
Davide Ippolito ◽  
Teresa Giandola ◽  
Cesare Maino ◽  
Davide Gandola ◽  
Maria Ragusi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow Involvement ◽  
Bone Lesion ◽  
Diagnostic Value ◽  
Lesion Detection ◽  
Lower Limbs ◽  
Whole Body ◽  
Bone Lesions ◽  
Whole Body Mri ◽  
Mri Protocol

The aim of the study is to evaluate the effectiveness of short whole-body magnetic resonance imaging (WBMRI) protocols for the overall assessment of bone marrow involvement in patients with multiple myeloma (MM), in comparison with standard whole-body MRI protocol. Patients with biopsy-proven MM, who underwent a WBMRI with full-body coverage (from vertex to feet) were retrospectively enrolled. WBMRI images were independently evaluated by two expert radiologists, in terms of infiltration patterns (normal, focal, diffuse, and combined), according to location (the whole skeleton was divided into six anatomic districts: skull, spine, sternum and ribs, upper limbs, pelvis and proximal two-thirds of the femur, remaining parts of lower limbs) and lytic lesions number (<5, 5–20, and >20). The majority of patients showed focal and combined infiltration patterns with bone lesions predominantly distributed in the spine and pelvis. As skull and lower limbs are less frequently involved by focal bone lesions, excluding them from the standard MRI protocol allows to obtain a shorter protocol, maintaining a good diagnostic value.

scholarly journals Evaluation of alpha-l-fucosidase for the diagnosis of hepatocellular carcinoma based on meta-analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Lei Xi ◽  
Chunqing Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Receiver Operating Characteristic Curves ◽  
Sensitivity Specificity ◽  
Review Manager

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.

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