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Meta-Analysis of the Accuracy of Abbreviated Magnetic Resonance Imaging for Hepatocellular Carcinoma Surveillance: Non-Contrast versus Hepatobiliary Phase-Abbreviated Magnetic Resonance Imaging

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Abstract
Simple Summary Ultrasonography is recommended as a standard surveillance modality, but the performance of surveillance ultrasound for detecting early-stage hepatocellular carcinoma (HCC) is limited. Motivated to provide a more sensitive method, abbreviated magnetic resonance imaging (AMRI) protocols have been introduced for HCC surveillance. We aimed to systematically determine the diagnostic performance of surveillance AMRI for detecting HCC. This meta-analysis of 10 studies comprising 1547 patients found that the pooled sensitivity and specificity of surveillance AMRI for detecting HCC were 86% and 96%, respectively. Hepatobiliary phase contrast-enhanced AMRI showed significantly higher sensitivities for detecting HCC than non-contrast AMRI (87% vs. 82%), but significantly lower specificities (93% vs. 98%). Therefore, surveillance AMRI had overall good diagnostic performance for detecting HCC and might be clinically useful for HCC surveillance. In addition, AMRI protocol should be selected with consideration of the advantages and disadvantages of each protocol. We aimed to determine the performance of surveillance abbreviated magnetic resonance imaging (AMRI) for detecting hepatocellular carcinoma (HCC), and to compare the performance of surveillance AMRI according to different protocols. Original research studies reporting the performance of surveillance AMRI for the detection of HCC were identified in MEDLINE, EMBASE, and Cochrane databases. The pooled sensitivity and specificity of surveillance AMRI were calculated using a hierarchical model. The pooled sensitivity and specificity of contrast-enhanced hepatobiliary phase (HBP)-AMRI and non-contrast (NC)-AMRI were calculated and compared using bivariate meta-regression. Ten studies, including 1547 patients, reported the accuracy of surveillance AMRI. The pooled sensitivity and specificity of surveillance AMRI for detecting any-stage HCC were 86% (95% confidence interval (CI), 80-90%; I-2 = 0%) and 96% (95% CI, 93-98%; I-2 = 80.5%), respectively. HBP-AMRI showed a significantly higher sensitivity for detecting HCC than NC-AMRI (87% vs. 82%), but significantly lower specificity (93% vs. 98%) (p = 0.03). Study quality and MRI magnet field strength were factors significantly associated with study heterogeneity (p <= 0.01). In conclusion, surveillance AMRI showed good overall diagnostic performance for detecting HCC. HBP-AMRI had significantly higher sensitivity for detecting HCC than NC-AMRI, but lower specificity.
Author(s)
김동환최상현심주현김소연이승수변재호최준일
Issued Date
2021
Type
Article
Keyword
hepatocellular carcinomaliverMRIsensitivityspecificitysurveillanceSystematic Review
DOI
10.3390/cancers13122975
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7392
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_a9d4fbd72d8b4a6287f334d12eacef20&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Meta-Analysis%20of%20the%20Accuracy%20of%20Abbreviated%20Magnetic%20Resonance%20Imaging%20for%20Hepatocellular%20Carcinoma%20Surveillance:%20Non-Contrast%20versus%20Hepatobiliary%20Phase-Abbreviated%20Magnetic%20Resonance%20Imaging&amp;offset=0&amp;pcAvailability=true
Publisher
CANCERS
Location
스위스
Language
영어
ISSN
2072-6694
Citation Volume
13
Citation Number
12
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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