The diagnostic performance of contrast-enhanced CT versus extracellular contrast agent-enhanced MRI in detecting hepatocellular carcinoma: direct comparison and a meta-analysis.

Abstract

To compare the diagnostic value of contrast-enhanced computed tomography (CT) with extracellular contrast agent-enhanced magnetic resonance imaging (ECA-MRI) for the detection of hepatocellular carcinoma (HCC). Pubmed, Embase, Web of Science and Cochrane Library were searched (1/5/2021) for studies comparing contrast-enhanced CT with ECA-MRI in patients suspected of HCC. Studies without head-to-head comparison were excluded. The pooled sensitivity, specificity and summary area under the curve (sAUC) of contrast-enhanced CT and ECA-MRI in detecting HCC was calculated based on bivariate random effects model. Heterogeneity test included threshold effect analysis and meta-regression. Subgroup analyses were conducted according to lesion size (< 20 mm or ≥ 20 mm). Overall, 10 articles containing 1333 patients were deemed suitable for inclusion in this meta-analysis. ECA-MRI displayed increased sensitivity to contrast-enhanced CT in detecting HCC (0.77 vs. 0.63, P < 0.01). The difference in specificity between ECA-MRI and contrast-enhanced CT was not statistically significant (0.93 vs. 0.94, P = 0.25). ECA-MRI yielded higher diagnostic accuracy (sAUCs = 0.88 vs. 0.80, P < 0.01). In the subgroup analysis with a lesion size < 20 mm, ECA-MRI allowed significant gains of accuracy compared to contrast-enhanced CT (0.79 vs. 0.72, P = 0.02). ECA-MRI also outperformed contrast-enhanced CT in patients with lesion size ≥ 20 mm (sAUCs = 0.96 vs. 0.93, P = 0.04). ECA-MRI provided higher sensitivity and accuracy than contrast-enhanced CT in detecting HCC, especially lesions size < 20 mm.

• Authors: Xi Chen, Mingkai Li, Ruomi Guo, Weimin Liu, Jianwen Li, Xiaodan Zong, Qilong Chen, Jin Wang
• Journal: Abdominal radiology (New York) (Abdom Radiol (NY)) Vol. 47 Issue 6 Pg. 2057-2070 (06 2022) ISSN: 2366-0058 [Electronic] United States
• PMID: 35312822 (Publication Type: Journal Article, Meta-Analysis, Review, Research Support, Non-U.S. Gov't)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Chemical References

• Contrast Media
• Gadolinium DTPA

Topics

• Carcinoma, Hepatocellular (diagnostic imaging)
• Contrast Media
• Gadolinium DTPA
• Humans
• Liver Neoplasms (diagnostic imaging)
• Magnetic Resonance Imaging (methods)
• Sensitivity and Specificity
• Tomography, X-Ray Computed