title: Magnetic resonance imaging with gadoxetic acid disodium for the detection of hepatocellular carcinoma: a meta-analysis of 18 studies.
abstract: OBJECTIVE
  To determine the accuracy of magnetic resonance imaging (MRI) with gadoxetic acid disodium for the detection of hepatocellular carcinoma (HCC).
  
  
  METHODS
  Various databases were searched for original articles published before May 2013. Studies were selected, which performed MRI with gadoxetic acid disodium to detect and diagnose HCC and which presented sufficient data to allow construction of contingency tables. For each study, the true-positive, false-positive, true-negative, and false-negative values were extracted or derived, and 2 × 2 contingency tables were constructed. The heterogeneity test, the threshold effect test, the publication bias analysis, and subgroup analyses were performed.
  
  
  RESULTS
  From 623 citations, 18 were included in the meta-analysis with a total of 2572 lesions. We detected heterogeneity between studies and evidence of publication bias. The methodological quality was moderate. The pooled weighted sensitivity was 0.91 (95% confidence interval [CI], 0.90-0.93), the specificity was 0.94 (95% CI, 0.93-0.96), the positive likelihood ratio was 12.31 (95% CI, 7.66-19.78), the negative likelihood ratio was 0.10 (95% CI, 0.07-0.13), and the diagnostic odds ratio was 159.72 (95% CI, 91.72-276.08). The area under the receiver operating characteristic curve was 0.98 (95% CI, 0.96-0.99).
  
  
  CONCLUSIONS
  MRI with gadoxetic acid disodium is a noninvasive and no radiation exposure imaging modality with high sensitivity and specificity for the detection of HCC. Nonetheless, it should be applied cautiously in liver nodule <1 cm, and large-scale well-designed trials are necessary to assess its clinical value.
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China; Department of Radiology, Taihu Hospital, Wuxi, Jiangsu Province, China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Minglong
authors.initials: M
authors.lastname: Liang
authors.affiliation: Clinical Laboratory, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Bao
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Jiuquan
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Taihu Hospital, Wuxi, Jiangsu Province, China.
authors.forename: Yunbao
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Xuanquan
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China. Electronic address: wangjian811@gmail.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Magnetic resonance imaging; gadoxetic acid; hepatocellular carcinoma; meta-analysis