Kim Dong Hwan, Kim Bohyun, Youn Seo Yeon, Kim Hokun, Choi Joon-Il
Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
Cancer Research Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea.
Diagnostics (Basel). 2021 Sep 25;11(10):1763. doi: 10.3390/diagnostics11101763.
Several imaging-based systems have been proposed for the diagnosis of hepatocellular carcinoma (HCC) using magnetic resonance imaging (MRI), reflecting geographical differences in the clinical environment for HCC. We conducted a systematic review and meta-analysis to determine the performance of the Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) 2018 criteria for the MRI diagnosis of HCC. Original studies reporting the performance of the KLCA-NCC 2018 criteria for the diagnosis of HCC using MRI were identified in MEDLINE and EMBASE until 29 March 2021. The meta-analytic pooled sensitivity and specificity of the KLCA-NCC 2018 criteria for diagnosing HCC were calculated using a bivariate random-effects model. A meta-regression analysis was performed to explore study heterogeneity further. Eight studies involving 1690 HCCs reported the accuracy of the KLCA-NCC 2018 imaging criteria. The pooled sensitivity and specificity of the definite HCC criteria for diagnosing HCC were 81% (95% confidence interval, 76-85%; = 86%) and 90% (86-93%; = 23%), respectively. For five available studies, the pooled sensitivity and specificity of the definite HCC criteria for diagnosing HCCs smaller than 20 mm were 80% (72-86%; = 76%) and 91% (86-94%; = 0%), respectively. A considerable threshold effect with a correlation coefficient of 0.667 was observed. The results of the meta-regression analysis revealed that the accuracy of the definite HCC criteria differed significantly depending on the type of MRI contrast agent ( = 0.01). In conclusion, the KLCA-NCC 2018 criteria had good overall diagnostic performance in diagnosing HCC. Substantial study heterogeneity was observed for sensitivity, which was significantly influenced by the type of contrast agent and by a threshold effect.
已经提出了几种基于成像的系统，用于利用磁共振成像（MRI）诊断肝细胞癌（HCC），这反映了HCC临床环境中的地域差异。我们进行了一项系统评价和荟萃分析，以确定韩国肝癌协会-国家癌症中心（KLCA-NCC）2018年HCC MRI诊断标准的性能。截至2021年3月29日，在MEDLINE和EMBASE中检索了报告KLCA-NCC 2018年使用MRI诊断HCC标准性能的原始研究。使用双变量随机效应模型计算KLCA-NCC 2018年诊断HCC标准的荟萃分析合并敏感性和特异性。进行荟萃回归分析以进一步探讨研究异质性。八项涉及1690例HCC的研究报告了KLCA-NCC 2018年成像标准的准确性。诊断HCC的明确HCC标准的合并敏感性和特异性分别为81%（95%置信区间，76-85%；I² = 86%）和90%（86-93%；I² = 23%）。对于五项可用研究，诊断小于20 mm的HCC的明确HCC标准的合并敏感性和特异性分别为80%（72-86%；I² = 76%）和91%（86-94%；I² = 0%）。观察到显著的阈值效应，相关系数为0.667。荟萃回归分析结果显示，明确HCC标准的准确性因MRI造影剂类型而异（P = 0.01）。总之，KLCA-NCC 2018年标准在诊断HCC方面具有良好的总体诊断性能。在敏感性方面观察到显著的研究异质性，这受到造影剂类型和阈值效应的显著影响。
