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Contrast-Enhanced Intraoperative Ultrasound Improved Sensitivity and Positive Predictive Value in Colorectal Liver Metastasis: a Systematic Review and Meta-Analysis

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The diagnostic accuracy of imaging modalities in colorectal cancer liver metastases (CRLM) has improved in recent years, therefore the role of current imaging techniques needs to be defined.

Objective

The aim of this study was to assess the diagnostic performance of magnetic resonance imaging, preoperative imaging (magnetic resonance imaging or computed tomography), intraoperative ultrasound, and contrast-enhanced intraoperative ultrasound in the detection of CRLM.

Materials and methods

Eligible trials published before 30 March 2020 were identified from the EMBASE, PubMed, Web of Science, and Cochrane Library databases, and descriptive and quantitative data were extracted. Study quality was evaluated for the identified studies and a random-effects model was used to determine the integrated diagnosis estimation. Meta-regression was implemented to explore the possible contributors to heterogeneity.

Results

Overall, 13 studies were included for analysis, comprising 682 patients with a total of 2303 liver lesions. The pooled sensitivity, specificity, and diagnostic odds ratio of contrast-enhanced intraoperative ultrasound were 0.94 (95% confidence interval [CI] 0.89–0.97), 0.83 (95% CI 0.67–0.92), and 79 (95% CI 32–196), respectively. The overall weighted area under the curve was 0.96 (95% CI 0.94–0.97). In univariate meta-regression analysis, disappearing liver metastasis, contrast agent, and Kupffer phase were the potent sources of heterogeneity; however, in multivariate meta-regression, no definite variable was the source of the study heterogeneity.

Conclusion

Contrast-enhanced intraoperative ultrasound demonstrated a high sensitivity and specificity for screening CRLM.

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Acknowledgment

No preregistration exists for the reported studies reported in this article. The authors would like to acknowledge Kun Wang, who contributed to the study by making substantial contributions to the acquisition of the data, and Hong-Wei Wang, who made substantial contributions to the analysis and interpretation of the data. Both Kun Wang and Hong-Wei Wang were involved in drafting of the manuscript but do not meet the criteria for authorship.

Funding

This study was supported by grants from the National Nature Science Foundation of China (umbers 81874143 and 31971192), the Beijing Natural Science Foundation (number 7192035), and Capital’s Funds for Health Improvement and Research (number 2020-2-2152).

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Author notes

  1. Wei Liu, Zhong-Yi Zhang, and Shan-Shan Yin have contributed equally to this work.

Authors and Affiliations

  1. Key Laboratory of Carcinogenesis and Translational Research, Hepatopancreatobiliary Surgery Department I, School of Oncology, Beijing Cancer Hospital and Institute, Peking University, Ministry of Education, Beijing, People’s Republic of China

    Wei Liu MD & Bao-Cai Xing MD

  2. Key Laboratory of Carcinogenesis and Translational Research, Department of Ultrasonography, School of Oncology, Beijing Cancer Hospital and Institute, Peking University, Ministry of Education, Beijing, People’s Republic of China

    Zhong-Yi Zhang MD, Shan-Shan Yin MD & Kun Yan MD

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  1. Wei Liu MD
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Corresponding authors

Correspondence to Kun Yan MD or Bao-Cai Xing MD.

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Potential Conflict of interestThis manuscript has not been previously submitted as a podium or poster presentation. Wei Liu, Zhong-Yi Zhang, Shan-Shan Yin, Kun Yan, and Bao-Cai Xing declare they have no financial or personal relationships with other people or organizations that can inappropriately influence this work, and there are no professional or other personal interests of any nature or kind, for any product, service, and/or company, in relation to this manuscript.

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Liu, W., Zhang, ZY., Yin, SS. et al. Contrast-Enhanced Intraoperative Ultrasound Improved Sensitivity and Positive Predictive Value in Colorectal Liver Metastasis: a Systematic Review and Meta-Analysis. Ann Surg Oncol 28, 3763–3773 (2021). https://doi.org/10.1245/s10434-020-09365-x

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