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Meta-Analysis
. 2016 Oct;41(10):1960-72.
doi: 10.1007/s00261-016-0807-7.

Diagnostic performance of contrast-enhanced multidetector computed tomography and gadoxetic acid disodium-enhanced magnetic resonance imaging in detecting hepatocellular carcinoma: direct comparison and a meta-analysis

Jin Guo  1 , Youngkwon Seo  2 , Shuo Ren  2 , Sunwoo Hong  3 , Dongki Lee  3 , Soyoun Kim  2 , Yuanyuan Jiang  4
Affiliations
Meta-Analysis

Diagnostic performance of contrast-enhanced multidetector computed tomography and gadoxetic acid disodium-enhanced magnetic resonance imaging in detecting hepatocellular carcinoma: direct comparison and a meta-analysis

Jin Guo et al. Abdom Radiol (NY). 2016 Oct.

Abstract

The purpose of this study was to directly (head-to-head) compare the per-lesion diagnostic performance of contrast-enhanced computed tomography (CT) (also referred to as CT hereafter) and gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging (also referred to as MRI hereafter) for the detection of hepatocellular carcinoma (HCC). Studies reporting direct per-lesion comparison data of contrast-enhanced multidetector CT and Gd-EOB-DTPA-enhanced MR imaging that were published between January 2000 and January 2015 were analyzed. The data of each study were extracted. Systematic review, paired meta-analysis, and subgroup analysis were performed. Twelve studies including 627 patients and 793 HCC lesions were analyzed. The sensitivity estimates of MRI and CT were, respectively, 0.86 (95% CI 0.76-0.93) and 0.70 (95% CI 0.58-0.80), with significant difference (P < 0.05). The sensitivity estimates were both 0.94 (95% CI 0.92-0.96) (Chi-square 4.84, degrees of freedom = 1, P > 0.05). In all subgroups, Gd-EOB-DTPA-enhanced MR imaging was more sensitive than multidetector CT for the detection of HCC, and specificity estimates of both tests maintained at a similarly high level in all conditions: sensitivity estimates of both tests were reduced in studies where patients were diagnosed with HCC solely by liver explant or in those where HCC lesions were small (≤2 cm, especially when ≤1 cm). But in all situations, sensitivities of MRI were higher than those of CT with or without significance. Gd-EOB-DTPA-enhanced MR imaging showed better per-lesion diagnostic performance than multidetector CT for the diagnosis of HCC in patients with cirrhosis and in small hepatic lesions.

Keywords: Computed tomography; Diagnosis; Gadoxetic acid disodium-enhanced magnetic resonance imaging; Hepatocellular carcinoma; Meta-analysis.

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Conflict of interest statement

Compliance with ethical standards Disclosure The scientific guarantor of this publication is JIANG Yuan Yuan. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Conflict of Interest There are no potential conflicts of interest, and there are no fund sources for the financial support. Ethical approval This article does not contain any studies with human participants or animals performed by any of the authors. This is a diagnostic study.

Figures

Fig. 1
Fig. 1
Flowchart illustrating the selection of studies
Fig. 2
Fig. 2
Methodological quality of the 20 included studies assessed with QUADAS-2 tools. A Risk of bias; B concerns regarding applicability
Fig. 3
Fig. 3
Forest plots showing per-lesion sensitivity and specificity with corresponding 95% Confidence Intervals (CIs) for the diagnosis of HCC by Gd-EOB-DTPA Enhanced MR imaging and multidetector CT in each study. The “Study” on the left was illustrated in the form of “first author/year/sample size”, “sample size” referring to the total number of lesions detected in a single study (please refer to Table 2). A Overall analysis; B Subgroup of studies using findings in explanted liver as the only reference; C Subgroup in which findings in explanted liver were not used as the only reference; D Further subgroup of studies in which patients were all diagnosed with cirrhosis; E Further subgroup of studies in which patients were partially diagnosed with cirrhosis
Fig. 4
Fig. 4
Paired SROC curves of Gd-EOB-DTPA-enhanced MR imaging (MRI) and multidetector CT (CT). A line connects the pair of points representing the tests of MRI and CT from each study
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References

    1. The World Health Organization. GLOBOCAN 2012. Available: http://globocan.iarc.fr/Pages/fact_sheets_canceraspx
    1. Yang JD, Roberts LR. Hepatocellular carcinoma: A global view. Nat Rev Gastroenterol Hepatol. 2010;7(8):448–458. doi: 10.1038/nrgastro.2010.100. - DOI - PMC - PubMed
    1. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53(3):1020–1022. doi: 10.1002/hep.24199. - DOI - PMC - PubMed
    1. European Association For The Study Of The Liver EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56(4):908–943. doi: 10.1016/j.jhep.2011.12.001. - DOI - PubMed
    1. Choi JY, Lee JM, Sirlin CB. CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part II. Extracellular agents, hepatobiliary agents, and ancillary imaging features. Radiology. 2014;273(1):30–50. doi: 10.1148/radiol.14132362. - DOI - PMC - PubMed

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