title: Gadoxetic acid disodium-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: a meta-analysis.
abstract: OBJECTIVE
  To determine the accuracy of MR imaging with gadoxetic acid disodium (Gd-EOB-DTPA) for the detection of hepatocelluar carcinoma (HCC).
  
  
  METHODS
  A systematic search was performed in PUBMED, EMBASE, Web of Science, Cochrane Library and the Chinese Biomedical Literature Database up to March 2013 to identify studies about evaluation of Gd-EOB-DTPA enhanced MR imaging in patients suspected of having HCC. The data were extracted to perform heterogeneity test and threshold effect test and to calculate sensitivity, specificity, diagnostic odds ratio, predictive value, and areas under summary receiver operating characteristic curve (AUC).
  
  
  RESULTS
  From 601 citations, 10 were included in the meta-analysis. The methodological quality of the 10 studies was good. Overall HCC: There was significant heterogeneity in the pooled analysis (I(2) = 69.4%, P = 0.0005), and the pooled weighted values were determined to be sensitivity: 0.91 (95% confidence interval (CI): 0.89, 0. 93); specificity: 0.95 (95% CI: 0.94, 0.96); diagnostic odds ratio: 169.94 (95% CI: 108.84, 265.36); positive likelihood ratio: 15.75 (95% CI: 7.45, 33.31); negative likelihood ratio: 0.10 (95% CI: 0.06, 0.15). The AUC was 0.9778. HCC in cirrhosis: The estimates were to be sensitivity: 0.91 (95% CI: 0.88, 0.93); specificity: 0.93 (95% CI: 0.89, 0.95); diagnostic odds ratio: 234.24 (95% CI: 33.47, 1639.25); positive likelihood ratio: 15.08 (95% CI: 2.20, 103.40); negative likelihood ratio: 0.08 (95% CI: 0.03, 0.21). The AUC was 0.9814. ≤20 mm HCC: The AUC was 0.9936. There was no notable publication bias.
  
  
  CONCLUSIONS
  This meta-analysis suggests that MR imaging with Gd-EOB-DTPA has high diagnostic accuracy for the detection of HCC, especially for ≤20 mm HCC. This technique shows good prospect in diagnosis of HCC.
authors: Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan province, China.
authors: Xijiao
authors: X
authors: Liu
authors: Li
authors: L
authors: Zou
authors: Fei
authors: F
authors: Liu
authors: Yin
authors: Y
authors: Zhou
authors: Bin
authors: B
authors: Song
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D017594:Publication Bias; D012372:ROC Curve
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
references: Hepatology. 1995 Jan;21(1):77-82
references: 7806171
references: Lancet. 2009 Feb 21;373(9664):614-6
references: 19231618
references: Nat Rev Drug Discov. 2010 Mar;9(3):215-36
references: 20190787
references: Invest Radiol. 2011 Apr;46(4):277-83
references: 21343827
references: Radiology. 2010 Sep;256(3):806-16
references: 20720069
references: J Magn Reson Imaging. 2011 Jul;34(1):69-78
references: 21598343
references: Clin Radiol. 2012 Feb;67(2):148-56
references: 21920517
references: Hepatology. 2000 Feb;31(2):330-5
references: 10655254
references: J Magn Reson Imaging. 1997 Jan-Feb;7(1):120-4
references: 9039601
references: CA Cancer J Clin. 2005 Mar-Apr;55(2):74-108
references: 15761078
references: Eur Radiol. 2011 Jun;21(6):1233-42
references: 21293864
references: J Clin Epidemiol. 2005 Sep;58(9):882-93
references: 16085191
references: Lancet. 1981 Nov 21;2(8256):1129-33
references: 6118576
references: AJR Am J Roentgenol. 2009 Jun;192(6):1675-81
references: 19457834
references: BMC Med Res Methodol. 2006 Jul 12;6:31
references: 16836745
references: Radiology. 2010 May;255(2):459-66
references: 20413759
references: Ann Intern Med. 2008 Dec 16;149(12):889-97
references: 19075208
references: Jpn J Radiol. 2012 Jan;30(1):25-33
references: 22160649
references: Semin Liver Dis. 2005;25(2):181-200
references: 15918147
references: Radiology. 1996 Jul;200(1):79-84
references: 8657948
references: Clin Radiol. 2010 May;65(5):358-65
references: 20380933
references: Radiology. 2010 Sep;256(3):817-26
references: 20663969
references: Oncol Lett. 2012 May;3(5):990-994
references: 22783378
references: Eur Radiol. 2012 Jun;22(6):1205-13
references: 22270142
references: BMC Med Res Methodol. 2006 Mar 06;6:9
references: 16519814
references: CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
references: 21296855
references: J Clin Epidemiol. 2005 Oct;58(10):982-90
references: 16168343
references: Korean J Radiol. 2010 Jul-Aug;11(4):433-40
references: 20592927
references: Z Gastroenterol. 2011 Jan;49(1):23-9
references: 21225534
references: Eur J Radiol. 2013 Jan;82(1):75-84
references: 23116806
references: CA Cancer J Clin. 2008 Mar-Apr;58(2):71-96
references: 18287387
references: Acad Radiol. 2002 May;9 Suppl 1:S119-20
references: 12019845
references: Radiology. 2012 Sep;264(3):761-70
references: 22843769
references: Radiology. 1996 Jul;200(1):59-67
references: 8657946
references: Int J Cancer. 1998 Jan 30;75(3):347-54
references: 9455792
references: Eur J Radiol. 2011 Nov;80(2):310-5
references: 20732773
references: BMC Med Res Methodol. 2003 Nov 10;3:25
references: 14606960
references: Hepatology. 2009 Feb;49(2):355-7
references: 19127518
references: AJR Am J Roentgenol. 2011 Jun;196(6):W758-65
references: 21606265
references: J Magn Reson Imaging. 2010 Feb;31(2):356-64
references: 20099349
references: Br J Radiol. 2010 Dec;83(996):1010-6
references: 20682591
references: Acta Radiol. 2012 Oct 1;53(8):830-8
references: 22847903
references: Lancet. 2003 Dec 6;362(9399):1907-17
references: 14667750
references: Magn Reson Imaging. 2013 Jun;31(5):748-54
references: 23218794
references: Radiology. 2011 Dec;261(3):834-44
references: 21998047
references: Eur J Radiol. 2012 Jul;81(7):1460-4
references: 21514080
references: J Magn Reson Imaging. 2013 Feb;37(2):398-406
references: 23011874
references: BMJ. 2003 Sep 6;327(7414):557-60
references: 12958120
references: Int J Surg. 2010;8(5):336-41
references: 20171303