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

Liu, Xijiao, Jiang, Hanyu, Chen, Jie, Zhou, You ORCID: https://orcid.org/0000-0002-1743-1291, Huang, Zixing and Song, Bin 2017. Gadoxetic acid-enhanced MRI outperformed MDCT in diagnosing small hepatocellular carcinoma: A meta-analysis. Liver Transplantation 23 (12) , pp. 1505-1518. 10.1002/lt.24867

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Abstract

Early detection of small hepatocellular carcinoma (HCC) lesions can improve longterm patient survival. A systematic review and meta-analysis of the diagnostic performance of gadoxetic acid disodium (Gd-EOB-DTPA)–enhanced magnetic resonance imaging (MRI) and multidetector computed tomography (MDCT) was performed in diagnosing small HCCs measuring up to 2 cm (≤2 cm). 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. A total of 27 studies (14 on Gd-EOB-DTPA–enhanced MRI, 9 on MDCT, and 4 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 versus 0.65; P < 0.01), without substantial loss of specificity (0.94 versus 0.98; P > 0.05). Area under the summary receiver operating characteristic curve was 0.97 with Gd-EOB-DTPA–enhanced MRI and 0.85 with MDCT. Regarding Gd-EOB-DTPA–enhanced MRI, sensitivity was significantly higher for studies from non-Asian countries than Asian countries (0.96 versus 0.93; P < 0.01), for retrospective studies than prospective studies (0.95 versus 0.91; P < 0.01), and for those with Gd-EOB-DTPA injection rate ≥ 1.5 mL/s than that of <1.5 mL/s (0.97 versus 0.90; P < 0.01). In conclusion, Gd-EOB-DTPA–enhanced MRI demonstrated higher sensitivity and overall diagnostic accuracy than MDCT, and thus should be the preferred imaging modality for diagnosing small HCCs measuring up to 2 cm. Liver Transplantation 23 1505–1518 2017 AASLD.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Systems Immunity Research Institute (SIURI)
Publisher:	John Wiley and Sons
ISSN:	1527-6465
Date of First Compliant Deposit:	20 September 2017
Date of Acceptance:	27 August 2017
Last Modified:	14 Nov 2024 14:45
URI:	https://orca.cardiff.ac.uk/id/eprint/104915

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