دورية أكاديمية
Noncontrast MRI for Hepatocellular Carcinoma Detection: A Systematic Review and Meta-analysis - A Potential Surveillance Tool?
| العنوان: | Noncontrast MRI for Hepatocellular Carcinoma Detection: A Systematic Review and Meta-analysis - A Potential Surveillance Tool? |
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| المؤلفون: | Chan MV; Department of Radiology, Concord Repatriation General Hospital, Sydney, Australia; Concord Hospital Clinical School, The University of Sydney, Sydney, Australia., Huo YR; Department of Radiology, Concord Repatriation General Hospital, Sydney, Australia; Concord Hospital Clinical School, The University of Sydney, Sydney, Australia., Trieu N; Department of Radiology, Concord Repatriation General Hospital, Sydney, Australia; Concord Hospital Clinical School, The University of Sydney, Sydney, Australia., Mitchelle A; Department of Radiology, Concord Repatriation General Hospital, Sydney, Australia., George J; Storr Liver Centre, Westmead Institute for Medical Research and Department of Gastroenterology and Hepatology, Westmead Hospital, University of Sydney, Sydney, Australia., He E; Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia., Lee AU; Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia., Chang J; Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia., Yang J; Department of Radiology, Concord Repatriation General Hospital, Sydney, Australia; Concord Hospital Clinical School, The University of Sydney, Sydney, Australia. Electronic address: jessica.yang1@health.nsw.gov.au. |
| المصدر: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2022 Jan; Vol. 20 (1), pp. 44-56.e2. Date of Electronic Publication: 2021 Mar 02. |
| نوع المنشور: | Journal Article; Meta-Analysis; Review; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: W.B. Saunders for the American Gastroenterological Association Country of Publication: United States NLM ID: 101160775 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1542-7714 (Electronic) Linking ISSN: 15423565 NLM ISO Abbreviation: Clin Gastroenterol Hepatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia, PA : W.B. Saunders for the American Gastroenterological Association, 2003- |
| مواضيع طبية MeSH: | Carcinoma, Hepatocellular*/diagnostic imaging , Carcinoma, Hepatocellular*/pathology , Liver Neoplasms*/diagnostic imaging , Liver Neoplasms*/pathology, Contrast Media ; Diffusion Magnetic Resonance Imaging/methods ; Humans ; Magnetic Resonance Imaging/methods ; Prospective Studies ; Sensitivity and Specificity |
| مستخلص: | Background and Aims: This meta-analysis investigates the diagnostic performance of non-contrast magnetic resonance imaging (MRI) for the detection of hepatocellular carcinoma (HCC). Methods: A systematic review was performed to May 2020 for studies which examined the diagnostic performance of non-contrast MRI (multi-sequence or diffusion-weighted imaging (DWI)- alone) for HCC detection in high risk patients. The primary outcome was accuracy for the detection of HCC. Random effects models were used to pool outcomes for sensitivity, specificity, positive likelihood ratio (LR) and negative LR. Subgroup analyses for cirrhosis and size of the lesion were performed. Results: Twenty-two studies were included involving 1685 patients for per-patient analysis and 2128 lesions for per-lesion analysis. Multi-sequence non-contrast MRI (NC-MRI) using T2+DWI±T1 sequences had a pooled per-patient sensitivity of 86.8% (95%CI:83.9-89.4%), specificity of 90.3% (95%CI:87.3-92.7%), and negative LR of 0.17 (95%CI:0.14-0.20). DWI-only MRI (DW-MRI) had a pooled sensitivity of 79.2% (95%CI:71.8-85.4%), specificity of 96.5% (95%CI:94.3-98.1%) and negative LR of 0.24 (95%CI:1.62-0.34). In patients with cirrhosis, NC-MRI had a pooled per-patient sensitivity of 87.3% (95%CI:82.7-91.0%) and specificity of 81.6% (95%CI:75.3-86.8%), whilst DWI-MRI had a pooled sensitivity of 71.4% (95%CI:60.5-80.8%) and specificity of 97.1% (95%CI:91.9-99.4%). For lesions <2 cm, the pooled per-lesion sensitivity was 77.1% (95%CI:73.8-80.2%). For lesions >2 cm, pooled per-lesion sensitivity was 88.5% (95%CI:85.0-91.5%). Conclusion: Non-contrast MRI has a moderate negative LR and high specificity with acceptable sensitivity for the detection of HCC, even in patients with cirrhosis and with lesions <2 cm. Prospective trials to validate if non-contrast MRI can be used for HCC surveillance is warranted. (Crown Copyright © 2022. Published by Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: Clin Gastroenterol Hepatol. 2022 Jan;20(1):25-27. (PMID: 33940226) |
| فهرسة مساهمة: | Keywords: Diffusion-Weighted Imaging; Hepatocellular Carcinoma; Magnetic Resonance Imaging; Meta-Analysis; Noncontrast |
| المشرفين على المادة: | 0 (Contrast Media) |
| تواريخ الأحداث: | Date Created: 20210304 Date Completed: 20220315 Latest Revision: 20220315 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.cgh.2021.02.036 |
| PMID: | 33662596 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1542-7714 |
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| DOI: | 10.1016/j.cgh.2021.02.036 |