3 years ago

Gadoxetic acid-enhanced MRI outperformed MDCT in diagnosing small hepatocellular carcinoma: A meta-analysis.

Zhou Y, Chen J, Jiang H, Huang Z, Liu X, Song B
Early detection of small hepatocellular carcinoma (HCC) lesions can improve long-term patient survival. A systematic review and meta-analysis of the diagnostic performance of gadoxetic acid disodium-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) and multidetector computed tomography (MDCT) was performed in diagnosing small HCCs measuring up to 2 cm(≤2cm). Two investigators searched multiple databases for studies in which the performances of either Gd-EOB-DTPA-enhanced MRI or MDCT were reported with sufficient data to construct 2 × 2 contingency tables for diagnosing HCCs up to 2 cm on a per-lesion or per-patient level. Diagnostic performances were quantitatively pooled by a bivariate random-effect model with further meta-regression and subgroup analyses. Twenty-seven studies (fourteen on Gd-EOB-DTPA-enhanced MRI, nine on MDCT and four on both) were included, enrolling a total of 1735 patients on Gd-EOB-DTPA-enhanced MRI and 1781 patients on MDCT. Gd-EOB-DTPA-enhanced MRI demonstrated significantly higher overall sensitivity than did MDCT (0.96 vs 0.65, p<0.01), without substantial loss of specificity (0.98 vs 0.94, p>0.05). Area under the summary receiver operating characteristic curve was 0.9712 with Gd-EOB-DTPA-enhanced MRI and 0.8538 with MDCT. Regarding Gd-EOB-DTPA-enhanced MRI, sensitivity was significantly higher for studies from non-Asian countries than Asian countries(0.96 vs 0.93, p<0.01), for retrospective studies than prospective studies(0.95 vs 0.91, p<0.01), and for those with Gd-EOB-DTPA injection rate≥1.5ml/s than that of<1.5ml/s (0.97 vs 0.90, p<0.01).

Publisher URL: https://www.ncbi.nlm.nih.gov/pubmed/28886231

DOI: PubMed:28886231

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