Abstract：
The ideal contrast agent for imaging patients with hepatocellular carcinoma (HCC) following locoregional therapies (LRT) remains uncertain. We conducted a meta-analysis to assess the diagnostic performance of magnetic resonance imaging with extracellular contrast agent (ECA-MRI) and hepatobiliary agent (EOB-MRI) in detecting residual or recurrence HCC following LRT.
Original studies comparing the diagnostic performance of ECA-MRI and EOB-MRI were systematically identified through comprehensive searches in PubMed, EMBASE, Cochrane Library and Web of Science databases. The pooled sensitivity and specificity of ECA-MRI and EOB-MRI were calculated using a bivariate-random-effects model. Subgroup-analyses were conducted to compare the diagnostic performance of ECA-MRI and EOB-MRI according to different variables. Meta-regression analysis was employed to explore potential sources of study heterogeneity.
A total of 15 eligible studies encompassing 803 patients and 1018 lesions were included. Comparative analysis revealed no significant difference between ECA-MRI and EOB-MRI in the overall pooled sensitivity (87% vs. 79%) and specificity (92% vs. 96%) for the detection of residual or recurrent HCC after LRT (P = 0.41), with comparable areas under the HSROC of 0.95 and 0.92. Subgroup analyses indicated no significant diagnostic performance differences between ECA-MRI and EOB-MRI according to study design, type of LRT, most common etiology of liver disease, baseline lesion size, time of post-treated examination and MRI field strength (All P > 0.05).
ECA-MRI exhibited overall comparable diagnostic performance to EOB-MRI in assessing residual or recurrent HCC after LRT.
Original studies comparing the diagnostic performance of ECA-MRI and EOB-MRI were systematically identified through comprehensive searches in PubMed, EMBASE, Cochrane Library and Web of Science databases. The pooled sensitivity and specificity of ECA-MRI and EOB-MRI were calculated using a bivariate-random-effects model. Subgroup-analyses were conducted to compare the diagnostic performance of ECA-MRI and EOB-MRI according to different variables. Meta-regression analysis was employed to explore potential sources of study heterogeneity.
A total of 15 eligible studies encompassing 803 patients and 1018 lesions were included. Comparative analysis revealed no significant difference between ECA-MRI and EOB-MRI in the overall pooled sensitivity (87% vs. 79%) and specificity (92% vs. 96%) for the detection of residual or recurrent HCC after LRT (P = 0.41), with comparable areas under the HSROC of 0.95 and 0.92. Subgroup analyses indicated no significant diagnostic performance differences between ECA-MRI and EOB-MRI according to study design, type of LRT, most common etiology of liver disease, baseline lesion size, time of post-treated examination and MRI field strength (All P > 0.05).
ECA-MRI exhibited overall comparable diagnostic performance to EOB-MRI in assessing residual or recurrent HCC after LRT.
摘要：
目的：局部区域治疗（LRT）后对肝细胞癌（HCC）患者成像的理想造影剂仍不确定。我们进行了一项荟萃分析，以评估使用细胞外造影剂（ECA-MRI）和肝胆制剂（EOB-MRI）的磁共振成像在检测LRT后残留或复发HCC中的诊断性能。
方法：比较ECA-MRI和EOB-MRI的诊断性能的原始研究是通过PubMed中的全面搜索系统确定的，EMBASE,Cochrane图书馆和WebofScience数据库。使用双变量随机效应模型计算ECA-MRI和EOB-MRI的合并敏感性和特异性。根据不同的变量进行亚组分析以比较ECA-MRI和EOB-MRI的诊断性能。采用Meta回归分析探讨研究异质性的潜在来源。
结果：共纳入15项符合条件的研究，包括803例患者和1018个病灶。比较分析显示，ECA-MRI和EOB-MRI在总体合并敏感性方面没有显着差异（87％vs.79%）和特异性（92%与96％）用于LRT后残留或复发的HCC的检测（P=0.41），HSROC为0.95和0.92以下的可比区域。亚组分析表明，根据研究设计，ECA-MRI和EOB-MRI之间的诊断性能无显著差异。轻轨类型,肝病最常见的病因，基线病变大小,治疗后检查时间和MRI场强（均P>0.05）。
结论：ECA-MRI在评估LRT后残留或复发的HCC方面表现出与EOB-MRI相当的总体诊断性能。
方法：比较ECA-MRI和EOB-MRI的诊断性能的原始研究是通过PubMed中的全面搜索系统确定的，EMBASE,Cochrane图书馆和WebofScience数据库。使用双变量随机效应模型计算ECA-MRI和EOB-MRI的合并敏感性和特异性。根据不同的变量进行亚组分析以比较ECA-MRI和EOB-MRI的诊断性能。采用Meta回归分析探讨研究异质性的潜在来源。
结果：共纳入15项符合条件的研究，包括803例患者和1018个病灶。比较分析显示，ECA-MRI和EOB-MRI在总体合并敏感性方面没有显着差异（87％vs.79%）和特异性（92%与96％）用于LRT后残留或复发的HCC的检测（P=0.41），HSROC为0.95和0.92以下的可比区域。亚组分析表明，根据研究设计，ECA-MRI和EOB-MRI之间的诊断性能无显著差异。轻轨类型,肝病最常见的病因，基线病变大小,治疗后检查时间和MRI场强（均P>0.05）。
结论：ECA-MRI在评估LRT后残留或复发的HCC方面表现出与EOB-MRI相当的总体诊断性能。
