Deng Yuhui, Li Jisheng, Xu Hui, Ren Ahong, Wang Zhenchang, Yang Dawei, Yang Zhenghan
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Medical Imaging Division, Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, Heilongjiang, China.
J Clin Transl Hepatol. 2022 Aug 28;10(4):642-650. doi: 10.14218/JCTH.2021.00254. Epub 2022 Jan 4.
Microvascular invasion (MVI) is a major risk factor for the early recurrence of hepatocellular carcinoma (HCC) and it seriously worsens the prognosis. Accurate preoperative evaluation of the presence of MVI could greatly benefit the treatment management and prognosis prediction of HCC patients. The study aim was to evaluate the diagnostic performance of the apparent diffusion coefficient (ADC), a quantitative parameter for the preoperative diagnosis MVI in HCC patients.
Original articles about diffusion-weighted imaging (DWI) and/or intravoxel incoherent motion (IVIM) conducted on a 3.0 or 1.5 Tesla magnetic resonance imaging (MRI) system indexed through January 17, 2021were collected from MEDLINE/PubMed, Web of Science, EMBASE, and the Cochrane Library. Methodological quality was evaluated using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). The pooled sensitivity, specificity, and summary area under the receiver operating characteristic curve (AUROC) were calculated, and meta-regression analysis was performed using a bivariate random effects model through a meta-analysis.
Nine original articles with a total of 988 HCCs were included. Most studies had low bias risk and minimal applicability concerns. The pooled sensitivity, specificity and AUROC of the ADC value were 73%, 70%, and 0.78, respectively. The time interval between the index test and the reference standard was identified as a possible source of heterogeneity by subgroup meta-regression analysis.
Meta-analysis showed that the ADC value had moderate accuracy for predicting MVI in HCC. The time interval accounted for the heterogeneity.
微血管侵犯（MVI）是肝细胞癌（HCC）早期复发的主要危险因素，严重恶化预后。术前准确评估MVI的存在对HCC患者的治疗管理和预后预测有很大益处。本研究旨在评估表观扩散系数（ADC）对HCC患者术前诊断MVI的诊断性能，ADC是一个定量参数。
从MEDLINE/PubMed、科学网、EMBASE和考克兰图书馆收集截至2021年1月17日在3.0或1.5特斯拉磁共振成像（MRI）系统上进行的关于扩散加权成像（DWI）和/或体素内不相干运动（IVIM）的原始文章。使用诊断准确性研究质量评估2（QUADAS-2）评估方法学质量。计算合并敏感性、特异性和受试者操作特征曲线下的汇总面积（AUROC），并通过荟萃分析使用双变量随机效应模型进行荟萃回归分析。
纳入9篇原始文章，共988例HCC。大多数研究的偏倚风险较低，适用性问题最小。ADC值的合并敏感性、特异性和AUROC分别为73%、70%和0.78。通过亚组荟萃回归分析确定指数测试与参考标准之间的时间间隔是异质性的一个可能来源。
荟萃分析表明，ADC值对预测HCC中的MVI具有中等准确性。时间间隔是异质性的原因。
