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Dig Dis Sci. 2013 Nov;58(11):3313-25. doi: 10.1007/s10620-013-2790-y. Epub 2013 Jul 25.

Is liver-specific gadoxetic acid-enhanced magnetic resonance imaging a reliable tool for detection of hepatocellular carcinoma in patients with chronic liver disease?

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  • 1Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dongfang Road, Shanghai, 200127, China.

Abstract

BACKGROUND:

Gadoxetic acid is a recently developed hepatobiliary-specific contrast material used for magnetic resonance imaging (MRI) which enables highly sensitive detection of hepatocellular carcinoma (HCC).

AIM:

We performed a meta-analysis of all available studies of the diagnostic performance of gadoxetic acid-enhanced MRI (Gd-EOB-MRI) for detection of HCC in patients with chronic liver disease.

METHODS:

Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 2000 to April 2012. Pooled estimation and subgroup analysis data were obtained by statistical analysis.

RESULTS:

Across 10 studies of 570 patients, Gd-EOB-MRI sensitivity was 0.91 (95 % CI 0.77, 0.97) and specificity was 0.93 (95 % CI 0.85, 0.97). Overall, LR+ was 13.6 (95 % CI 5.6, 33.2), LR- was 0.10 (95 % CI 0.04, 0.27), and DOR was 140.36 (95 % CI 28, 696). Among patients with high pre-test probabilities, MRI enabled confirmation of HCC; among patients with low pre-test probabilities, MRI enabled exclusion of HCC. Worst-case-scenario (pre-test probability, 50 %) post-test probabilities were 93 and 9 % for positive and negative MRI results, respectively. In studies in which both Gd-EOB-MRI and contrast enhanced computed tomography (CE-CT) were performed, Gd-EOB-MRI was more sensitive than CE-CT (0.93 vs. 0.78; p < 0.05). Subgroup analysis suggested average lesion size (<2 vs. >2 cm) did not affect the diagnostic accuracy of the test (p > 0.05).

CONCLUSIONS:

A limited number of small studies suggest Gd-EOB-MRI has good diagnostic performance in the detection of HCC among patients with chronic liver disease. It is also confirmed to be a reliable tool for evaluation of small early-stage HCC.

PMID:
23884757
[PubMed - indexed for MEDLINE]
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