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MRI Features for Predicting Microvascular Invasion of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

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Abstract
Purpose: Microvascular invasion (MVI) is an important prognostic factor in patients with hepatocellular carcinoma (HCC). However, the reported results of magnetic resonance imaging (MRI) features for predicting MVI of HCC are variable and conflicting. Therefore, this meta-analysis aimed to identify the significant MRI features for MVI of HCC and to determine their diagnostic value. Methods: Original studies reporting the diagnostic performance of MRI for predicting MVI of HCC were identified in MEDLINE and EMBASE up until January 15, 2020. Study quality was assessed using QUADAS-2. A bivariate random-effects model was used to calculate the meta-analytic pooled diagnostic odds ratio (DOR) and 95% confidence interval (CI) for each MRI feature for diagnosing MVI in HCC. The meta-analytic pooled sensitivity and specificity were calculated for the significant MRI features. Results: Among 235 screened articles, we found 36 studies including 4,274 HCCs. Of the 15 available MRI features, 7 were significantly associated with MVI: larger tumor size (>5 cm) (DOR = 5.2, 95% CI [3.0-9.0]), rim arterial enhancement (4.2, 95% CI [1.7-10.6]), arterial peritumoral enhancement (4.4, 95% CI [2.8-6.9]), peritumoral hypointensity on hepatobiliary phase imaging (HBP) (8.2, 95% CI [4.4-15.2]), nonsmooth tumor margin (3.2, 95% CI [2.2-4.4]), multifocality (7.1, 95% CI [2.6-19.5]), and hypointensity on T1-weighted imaging (T1WI) (4.9, 95% CI [2.5-9.6]). Both peritumoral hypointensity on HBP and multifocality showed very high meta-analytic pooled specificities for diagnosing MVI (91.1% [85.4-94.8%] and 93.3% [74.5-98.5%], respectively). Conclusions: Seven MRI features including larger tumor size, rim arterial enhancement, arterial peritumoral enhancement, peritumoral hypointensity on HBP, nonsmooth margin, multifocality, and hypointensity on T1WI were significant predictors for MVI of HCC. These MRI features predictive of MVI can be useful in the management of HCC.
Author(s)
홍승백최상현김소연심주현이승수변재호박성호김경원김석이남경
Issued Date
2021
Type
Article
Keyword
DiagnosisHepatocellular carcinomaLiver cancerMagnetic resonance imagingMedical diagnosisMeta-AnalysisMicrovascular invasionStatistical analysisSystematic review
DOI
10.1159/000513704
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7051
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_karger_primary_513704&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,MRI%20Features%20for%20Predicting%20Microvascular%20Invasion%20of%20Hepatocellular%20Carcinoma:%20A%20Systematic%20Review%20and%20Meta-Analysis&offset=0&pcAvailability=true
Publisher
LIVER CANCER
Location
스위스
Language
영어
ISSN
2235-1795
Citation Volume
10
Citation Number
2
Citation Start Page
94
Citation End Page
106
Appears in Collections:
Medicine > Medicine
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