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. 2022 Jun 24:12:907076.
doi: 10.3389/fonc.2022.907076. eCollection 2022.

Peritumoral Imaging Manifestations on Gd-EOB-DTPA-Enhanced MRI for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Ying Wu  1   2 , Meilin Zhu  1 , Yiming Liu  3 , Xinyue Cao  1 , Guojin Zhang  1 , Longlin Yin  1
Affiliations

Peritumoral Imaging Manifestations on Gd-EOB-DTPA-Enhanced MRI for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Ying Wu et al. Front Oncol. .

Abstract

Purpose: The aim was to investigate the association between microvascular invasion (MVI) and the peritumoral imaging features of gadolinium ethoxybenzyl DTPA-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) in hepatocellular carcinoma (HCC).

Methods: Up until Feb 24, 2022, the PubMed, Embase, and Cochrane Library databases were carefully searched for relevant material. The software packages utilized for this meta-analysis were Review Manager 5.4.1, Meta-DiSc 1.4, and Stata16.0. Summary results are presented as sensitivity (SEN), specificity (SPE), diagnostic odds ratios (DORs), area under the receiver operating characteristic curve (AUC), and 95% confidence interval (CI). The sources of heterogeneity were investigated using subgroup analysis.

Results: An aggregate of nineteen articles were remembered for this meta-analysis: peritumoral enhancement on the arterial phase (AP) was described in 13 of these studies and peritumoral hypointensity on the hepatobiliary phase (HBP) in all 19 studies. The SEN, SPE, DOR, and AUC of the 13 investigations on peritumoral enhancement on AP were 0.59 (95% CI, 0.41-0.58), 0.80 (95% CI, 0.75-0.85), 4 (95% CI, 3-6), and 0.73 (95% CI, 0.69-0.77), respectively. The SEN, SPE, DOR, and AUC of 19 studies on peritumoral hypointensity on HBP were 0.55 (95% CI, 0.45-0.64), 0.87 (95% CI, 0.81-0.91), 8 (95% CI, 5-12), and 0.80 (95% CI, 0.76-0.83), respectively. The subgroup analysis of two imaging features identified ten and seven potential factors for heterogeneity, respectively.

Conclusion: The results of peritumoral enhancement on the AP and peritumoral hypointensity on HBP showed high SPE but low SEN. This indicates that the peritumoral imaging features on Gd-EOB-DTPA-enhanced MRI can be used as a noninvasive, excluded diagnosis for predicting hepatic MVI in HCC preoperatively. Moreover, the results of this analysis should be updated when additional data become available. Additionally, in the future, how to improve its SEN will be a new research direction.

Keywords: Gd-EOB-DTPA-enhanced MRI; hepatocellular carcinoma; meta-analysis; microvascular invasion; peritumoral enhancement; peritumoral hypointensity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram illustrating the search strategy.
Figure 2
Figure 2
Methodological quality summary of all included studies by using Quality Assessment of Diagnostic Accuracy Studies.
Figure 3
Figure 3
Forest plots demonstrate the pooled sensitivity and specificity of peritumoral enhancement on the arterial phase. The 95% CI are shown around point estimates and the pooled result.
Figure 4
Figure 4
Summary receiver operating characteristic curves of peritumoral enhancement on the arterial phase.
Figure 5
Figure 5
Forest plots demonstrate the pooled sensitivity and specificity of peritumoral hypointensity on the hepatobiliary phase. The 95% CI are shown around point estimates and the pooled result.
Figure 6
Figure 6
Summary receiver operating characteristic curves of peritumoral hypointensity on the hepatobiliary phase.
Figure 7
Figure 7
Deeks' functional plots of peritumoral enhancement on the arterial phase (A) and peritumoral hypointension on the hepatobiliary phase (B).
See this image and copyright information in PMC

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