The diagnostic performance of gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced multi-detector computed tomography in detecting hepatocellular carcinoma: a meta-analysis of eight prospective studies
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The purpose of this study was to determine the relative diagnostic benefit of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)–enhanced magnetic resonance imaging (MRI) over contrast-enhanced multi-detector computed tomography (CEMDCT) for the detection of hepatocellular carcinoma (HCC).
Two investigators searched multiple databases from inception to January 8, 2019, for studies comparing Gd-EOB-DTPA-enhanced MRI with CEMDCT in adults suspected of HCC. Two reviewers independently selected studies and extracted data.
Eight studies were included enrolling 498 patients. MRI showed significantly higher sensitivity than CT (0.85 vs. 0.68). There was no significant difference in the specificity of MRI and CT (0.94 vs. 0.93). The negative likelihood ratio and positive likelihood ratio of MRI and CT were not significantly different (0.16 vs. 0.15 and 14.7 vs. 11.2, respectively). The summary receiver operating characteristics (SROC) of MRI was higher than that of CT at 0.96 vs. 0.91. In the subgroup analysis with a lesion diameter below 2 cm, the sensitivity of MRI was significantly higher than that of CT (0.79 vs. 0.46).
Gd-EOB-DTPA-enhanced MRI showed higher sensitivity and overall diagnostic accuracy than CEMDCT especially for hepatocellular carcinoma lesions smaller than 2 cm.
• Gd-EOB-DTPA-enhanced MRI can detect small lesions of hepatocellular carcinoma.
• Gd-EOB-DTPA-enhanced MRI showed higher sensitivity and overall diagnostic accuracy than CEMDCT in patients with hepatocellular carcinoma.
• Eight prospective studies showed that Gd-EOB-DTPA-enhanced MRI provides greater diagnostic confidence.
KeywordsHepatocellular carcinoma Gadoxetic acid disodium Magnetic resonance imaging Tomography, X-ray computed Meta-analysis
Contrast-enhanced multi-detector computed tomography
Dynamic contrast enhanced
Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid
Magnetic resonance imaging
This study has received funding by the State Key Program of National Natural Science Foundation of China (No. 81430014); the National Natural Science Foundation of China (No. 81660103, No. 81771674); 111 Project (D17011); the National Institutes of Health (R01DK102912); Guangxi BaGui Scholars, Project of Guangxi Health and Family Planning Commission (No. S201602); the Project of Guangxi University Collaborative Innovation Center; the project to improve middle-aged and young teachers’ basic ability in universities of Guangxi (KY2016YB326); and Guangxi Key Laboratory of Molecular Medicine in Liver Injury and Repair(No. 16-140-46-04).
Compliance with ethical standards
The scientific guarantor of this publication is Songqing He.
Conflict of interest
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.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was not required for this study because it is a meta-analysis.
Institutional Review Board approval was not required because it is a meta-analysis.
• multicenter study
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