Wu Ying, Zhu Meilin, Liu Yiming, Cao Xinyue, Zhang Guojin, Yin Longlin
Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Front Oncol. 2022 Jun 24;12:907076. doi: 10.3389/fonc.2022.907076. eCollection 2022.
The aim was to investigate the association between microvascular invasion (MVI) and the peritumoral imaging features of gadolinium ethoxybenzyl DTPA-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) in hepatocellular carcinoma (HCC).
Up until Feb 24, 2022, the PubMed, Embase, and Cochrane Library databases were carefully searched for relevant material. The software packages utilized for this meta-analysis were Review Manager 5.4.1, Meta-DiSc 1.4, and Stata16.0. Summary results are presented as sensitivity (SEN), specificity (SPE), diagnostic odds ratios (DORs), area under the receiver operating characteristic curve (AUC), and 95% confidence interval (CI). The sources of heterogeneity were investigated using subgroup analysis.
An aggregate of nineteen articles were remembered for this meta-analysis: peritumoral enhancement on the arterial phase (AP) was described in 13 of these studies and peritumoral hypointensity on the hepatobiliary phase (HBP) in all 19 studies. The SEN, SPE, DOR, and AUC of the 13 investigations on peritumoral enhancement on AP were 0.59 (95% CI, 0.41-0.58), 0.80 (95% CI, 0.75-0.85), 4 (95% CI, 3-6), and 0.73 (95% CI, 0.69-0.77), respectively. The SEN, SPE, DOR, and AUC of 19 studies on peritumoral hypointensity on HBP were 0.55 (95% CI, 0.45-0.64), 0.87 (95% CI, 0.81-0.91), 8 (95% CI, 5-12), and 0.80 (95% CI, 0.76-0.83), respectively. The subgroup analysis of two imaging features identified ten and seven potential factors for heterogeneity, respectively.
The results of peritumoral enhancement on the AP and peritumoral hypointensity on HBP showed high SPE but low SEN. This indicates that the peritumoral imaging features on Gd-EOB-DTPA-enhanced MRI can be used as a noninvasive, excluded diagnosis for predicting hepatic MVI in HCC preoperatively. Moreover, the results of this analysis should be updated when additional data become available. Additionally, in the future, how to improve its SEN will be a new research direction.
本研究旨在探讨肝细胞癌（HCC）中微血管侵犯（MVI）与钆塞酸二钠增强磁共振成像（Gd-EOB-DTPA增强MRI）瘤周影像特征之间的关联。
截至2022年2月24日，我们仔细检索了PubMed、Embase和Cochrane图书馆数据库中的相关资料。本荟萃分析使用的软件包为Review Manager 5.4.1、Meta-DiSc 1.4和Stata16.0。汇总结果以敏感度（SEN）、特异度（SPE）、诊断比值比（DOR）、受试者操作特征曲线下面积（AUC）和95%置信区间（CI）表示。采用亚组分析研究异质性来源。
本荟萃分析共纳入19篇文章：其中13项研究描述了动脉期（AP）瘤周强化情况，所有19项研究均描述了肝胆期（HBP）瘤周低信号情况。13项关于AP期瘤周强化研究的SEN、SPE、DOR和AUC分别为0.59（95%CI，0.41-0.58）、0.80（95%CI，0.75-0.85）、4（95%CI，3-6）和0.73（95%CI，0.69-0.77）。19项关于HBP期瘤周低信号研究的SEN、SPE、DOR和AUC分别为0.55（95%CI，0.45-0.64）、0.87（95%CI，0.81-0.91）、8（95%CI）、5-12）和0.80（95%CI，0.76-0.83）。对这两种影像特征的亚组分析分别确定了10个和7个潜在的异质性因素。
AP期瘤周强化及HBP期瘤周低信号结果显示SPE高但SEN低。这表明Gd-EOB-DTPA增强MRI的瘤周影像特征可作为术前预测HCC肝内MVI的一种非侵入性排除诊断方法。此外，当有更多数据时，本分析结果应更新。另外，未来如何提高其SEN将是一个新的研究方向。
