Department of Radiology, First Hospital of Lanzhou University, Lanzhou, Gansu, China.
Department of Nuclear Medicine, Second Hospital of Lanzhou University, Lanzhou, Gansu, China.
Curr Med Imaging. 2022;18(6):633-647. doi: 10.2174/1573405617666210917124404.
Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid (Gd- EOB-DTPA) has become a widely used liver-specific contrast agent worldwide, but its value and limitations as a diagnostic technique with Hepatocellular Carcinoma (HCC), have not been assessed.
A review of the latest evidence available on the diagnostic value of Gd-EOB-DTPA- enhanced MRI for the evaluation of HCC is reported.
A systematic, comprehensive literature search was conducted with PubMed, Scopus, EMBASE, the Web of Science, the Cochrane Library, CNKI, vip, wanfangdata and CBM from inception to June 31, 2020. The QUADAS-2 tool was used to evaluate the quality of the included studies. Pooled Sensitivity (SEN), Pooled Specificity (SPE), pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio (dOR) and summary receiver operating characteristic (SROC) curves were calculated to assess the diagnostic value of the individual diagnostic tests.
A total of 47 articles were included, involving a total of 6362 nodules in 37 studies based on per-lesion studies. There were 13 per-patient studies, including a total of 1816 patients. The results of the meta-analysis showed that the per-lesion studies pooled weighted values were SEN 0.90 [95% confidence interval (CI): 0.87-0.92], SPE 0.92 (95% CI: 0.90-0.94), PLR 11.6 (95% CI: 8.8-15.2), NLR 0.11 (95% CI: 0.09-0.14) and dOR 107.0 (95% CI: 74.0-155.0). The AUC of the SROC curve was 0.96. The per-patient studies pooled weighted values were SEN 0.84 [95% confidence interval (CI): 0.78-0.89], SPE 0.92 (95% CI: 0.88-0.94), PLR 10.4 (95% CI: 7.4-14.6), NLR 0.17 (95% CI: 0.12-0.24) and dOR 61.0 (95% CI: 42.0-87.0). The AUC of the SROC curve was 0.95 and subgroup analyses were performed.
The diagnostic value of Gd-EOB-DTPA for HCC was quantitatively evaluated in a per-lesion study and a per-patient study using a systematic review of the literature. A positive conclusion was drawn: Gd-EOB-DTPA-enhanced imaging is a valuable diagnostic technique for HCC. The size of the nodules and the selection of the imaging diagnostic criteria may affect the diagnostic sensitivity.
钆塞酸二乙三胺五乙酸（Gd-EOB-DTPA）已成为全球广泛使用的肝脏特异性对比剂，但尚未评估其作为肝细胞癌（HCC）诊断技术的价值和局限性。
报告了对 Gd-EOB-DTPA 增强 MRI 对 HCC 评估的最新诊断价值的最新证据进行的系统综述。
从开始到 2020 年 6 月 31 日，使用 PubMed、Scopus、EMBASE、Web of Science、Cochrane 图书馆、CNKI、vip、wanfangdata 和 CBM 对文献进行了系统、全面的文献检索。使用 QUADAS-2 工具评估纳入研究的质量。计算了个体诊断试验的汇总敏感性（SEN）、汇总特异性（SPE）、汇总阳性似然比（PLR）、汇总阴性似然比（NLR）、汇总诊断比值比（dOR）和汇总受试者工作特征（SROC）曲线，以评估诊断价值。
共纳入 47 篇文章，其中 37 项基于病变的研究共涉及 6362 个结节，13 项基于患者的研究共涉及 1816 例患者。荟萃分析结果显示，病变研究的汇总加权值分别为 SEN 0.90[95%置信区间（CI）：0.87-0.92]、SPE 0.92（95%CI：0.90-0.94）、PLR 11.6（95%CI：8.8-15.2）、 NLR 0.11（95%CI：0.09-0.14）和 dOR 107.0（95%CI：74.0-155.0）。SROC 曲线的 AUC 为 0.96。患者研究的汇总加权值分别为 SEN 0.84[95%置信区间（CI）：0.78-0.89]、SPE 0.92（95%CI：0.88-0.94）、PLR 10.4（95%CI：7.4-14.6）、 NLR 0.17（95%CI：0.12-0.24）和 dOR 61.0（95%CI：42.0-87.0）。SROC 曲线的 AUC 为 0.95，并进行了亚组分析。
通过系统文献复习对病变和患者研究进行了 Gd-EOB-DTPA 对 HCC 的诊断价值的定量评估。得出了一个积极的结论：Gd-EOB-DTPA 增强成像技术是一种有价值的 HCC 诊断技术。结节的大小和影像学诊断标准的选择可能会影响诊断灵敏度。
