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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

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Aim

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).

Methods

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.

Results

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).

Conclusion

Gd-EOB-DTPA-enhanced MRI showed higher sensitivity and overall diagnostic accuracy than CEMDCT especially for hepatocellular carcinoma lesions smaller than 2 cm.

Key Points

• 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.

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Abbreviations

CEMDCT:

Contrast-enhanced multi-detector computed tomography

DCE:

Dynamic contrast enhanced

FN:

False negative

FP:

False positive

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid

HCC:

Hepatocellular carcinoma

MRI:

Magnetic resonance imaging

TN:

True negative

TP:

True positive

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Funding

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).

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China

    Jiangfa Li, Jiming Wang, Liping Lei, Guandou Yuan & Songqing He

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  1. Jiangfa Li
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  2. Jiming Wang
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  3. Liping Lei
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  5. Songqing He
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Correspondence to Songqing He.

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The scientific guarantor of this publication is Songqing He.

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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.

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Written informed consent was not required for this study because it is a meta-analysis.

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Institutional Review Board approval was not required because it is a meta-analysis.

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• prospective

• multicenter study

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Li, J., Wang, J., Lei, L. et al. 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. Eur Radiol 29, 6519–6528 (2019). https://doi.org/10.1007/s00330-019-06294-6

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  • DOI: https://doi.org/10.1007/s00330-019-06294-6

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