Abstract
The purpose of this study was to directly (head-to-head) compare the per-lesion diagnostic performance of contrast-enhanced computed tomography (CT) (also referred to as CT hereafter) and gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging (also referred to as MRI hereafter) for the detection of hepatocellular carcinoma (HCC). Studies reporting direct per-lesion comparison data of contrast-enhanced multidetector CT and Gd-EOB-DTPA-enhanced MR imaging that were published between January 2000 and January 2015 were analyzed. The data of each study were extracted. Systematic review, paired meta-analysis, and subgroup analysis were performed. Twelve studies including 627 patients and 793 HCC lesions were analyzed. The sensitivity estimates of MRI and CT were, respectively, 0.86 (95% CI 0.76–0.93) and 0.70 (95% CI 0.58–0.80), with significant difference (P < 0.05). The sensitivity estimates were both 0.94 (95% CI 0.92–0.96) (Chi-square 4.84, degrees of freedom = 1, P > 0.05). In all subgroups, Gd-EOB-DTPA-enhanced MR imaging was more sensitive than multidetector CT for the detection of HCC, and specificity estimates of both tests maintained at a similarly high level in all conditions: sensitivity estimates of both tests were reduced in studies where patients were diagnosed with HCC solely by liver explant or in those where HCC lesions were small (≤2 cm, especially when ≤1 cm). But in all situations, sensitivities of MRI were higher than those of CT with or without significance. Gd-EOB-DTPA-enhanced MR imaging showed better per-lesion diagnostic performance than multidetector CT for the diagnosis of HCC in patients with cirrhosis and in small hepatic lesions.Electronic supplementary materialThe online version of this article (doi:10.1007/s00261-016-0807-7) contains supplementary material, which is available to authorized users.
Highlights
0.70, with significant difference (P < 0.05)
Gd-EOB-DTPAenhanced magnetic resonance (MR) imaging was more sensitive than multidetector computed tomography (CT) for the detection of Hepatocellular carcinoma (HCC), and specificity estimates of both tests maintained at a high level in all conditions: sensitivity estimates of both tests were reduced in studies where patients were diagnosed with HCC solely by liver explant or in those where HCC lesions were small (£2 cm, especially when £1 cm)
We provide details on how the literature was searched in various databases a Medical subject headings protein, or diagnosed with HCC retrospectively; (c) sample size larger than ten patients; (d) diagnostic results of true positive (TP), false positive (FP), false negative (FN), and true negative (TN) were available; (e) both CT and MR imaging were performed by multiphasic contrast-enhanced imaging with Gd-EOB-DTPA as one of the contrast agents for MR imaging; (f) a CT detector row of at least four and an MR imaging magnetic field strength > 1.0T; and (g) reference standards were based on histopathology and/or a clinical follow-up of at least 6 months
Summary
This meta-analysis was performed in accordance with the recommendations outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) [17].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
