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Gadoxetic acid disodium–enhanced magnetic resonance imaging outperformed multidetector computed tomography in diagnosing small hepatocellular carcinoma: A meta‐analysis
Author(s) -
Liu Xijiao,
Jiang Hanyu,
Chen Jie,
Zhou You,
Huang Zixing,
Song Bin
Publication year - 2017
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.24867
Subject(s) - gadoxetic acid , medicine , hepatocellular carcinoma , magnetic resonance imaging , meta analysis , nuclear medicine , radiology , receiver operating characteristic , gadolinium dtpa
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.