Department of Radiology, Zhongda Hospital, Jiangsu Key Laboratory of Molecular and Functional Imaging, School of Medicine, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, China.
Department of Gastroenterology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha, 410007, Hunan, China.
Abdom Radiol (NY). 2024 Feb;49(2):471-483. doi: 10.1007/s00261-023-04143-1. Epub 2024 Jan 10.
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.
用于成像局部治疗（LRT）后肝细胞癌（HCC）患者的理想对比剂仍不确定。我们进行了一项荟萃分析，以评估细胞外对比剂（ECA-MRI）和肝胆对比剂（EOB-MRI）在检测 LRT 后残留或复发性 HCC 的诊断性能。
通过全面搜索 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 数据库，系统地确定了比较 ECA-MRI 和 EOB-MRI 诊断性能的原始研究。使用双变量随机效应模型计算 ECA-MRI 和 EOB-MRI 的汇总敏感性和特异性。进行亚组分析，根据不同变量比较 ECA-MRI 和 EOB-MRI 的诊断性能。采用元回归分析探讨研究异质性的潜在来源。
共纳入 15 项符合条件的研究，包括 803 名患者和 1018 个病灶。对比分析显示，LRT 后残留或复发 HCC 的总体汇总敏感性（87%对 79%）和特异性（92%对 96%）方面，ECA-MRI 和 EOB-MRI 之间无统计学差异（P=0.41），HSROC 下面积相似，分别为 0.95 和 0.92。亚组分析表明，根据研究设计、LRT 类型、最常见的肝病病因、基线病变大小、治疗后检查时间和 MRI 场强，ECA-MRI 和 EOB-MRI 之间的诊断性能差异无统计学意义（均 P>0.05）。
在评估 LRT 后残留或复发性 HCC 方面，ECA-MRI 的总体诊断性能与 EOB-MRI 相当。
