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Gadoxetic acid‐enhanced MRI for the characterization of hepatocellular carcinoma: A systematic review and meta‐analysis
Author(s) -
Duncan Joanna K.,
Ma Ning,
Vreugdenburg Thomas D.,
Cameron Alun L.,
Maddern Guy
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25345
Subject(s) - gadoxetic acid , medicine , hepatocellular carcinoma , magnetic resonance imaging , confidence interval , meta analysis , nuclear medicine , radiology , cochrane library , gadolinium dtpa
Purpose To establish the relative diagnostic accuracy of gadoxetic acid‐enhanced magnetic resonance imaging (GA‐MRI) compared with contrast‐enhanced computed tomography (CE‐CT), dynamic MRI (D‐MRI), gadopentetic acid‐enhanced MRI (GP‐MRI), or gadobenic acid‐enhanced MRI (GB‐MRI) in the characterization of hepatocellular carcinoma (HCC). Materials and Methods PubMed, EMBASE, the Cochrane Library, and the University of York CRD databases were searched to February 29 2016 for any studies that compared the diagnostic accuracy of GA‐MRI to CE‐CT, D‐MRI, GP‐MRI, or GB‐MRI in patients with known or suspected HCC. Diagnostic accuracy outcomes (true positive, true negative, false positive, false negative) were extracted and analyzed using the bivariate model of Reitsma et al (2005). Results In studies comparing GA‐MRI to CE‐CT in patients with any‐sized lesions, estimated sensitivities were 0.881 (95% confidence interval [CI] = 0.766, 0.944) and 0.713 (95% CI = 0.577, 0.819) respectively. Estimated specificities were 0.926 (95% CI = 0.829, 0.97) and 0.918 (95% CI = 0.829, 0.963), respectively. This difference was not statistically significant. In studies including patients with small lesions GA‐MRI was superior to CE‐CT, with estimated sensitivities of 0.919 (95% CI = 0.834, 0.962) and 0.637 (95% CI = 0.565, 0.704 and estimated specificities of 0.936 (95% CI = 0.882, 0.966) and 0.971 (95% CI = 0.937, 0.987), respectively. In studies comparing GA‐MRI to D‐MRI in patients with any‐sized lesions estimated sensitivities were 0.907 (95% CI = 0.870, 0.934) and 0.820 (95% CI = 0.776, 0.857); estimated specificities were 0.929 (95% CI = 0.877, 0.961) and 0.934 (95% CI = 0.881, 0.964). Conclusion GA‐MRI has superior diagnostic ability to CE‐CT in patients with small lesions. In patients with any‐sized lesions there is no evidence that GA‐MRI is superior to either CE‐CT to D‐MRI. Level of Evidence: 3 J. Magn. Reson. Imaging 2017;45:281–290.