title: Differential diagnosis between hepatic metastases and benign focal lesions using DWI with parallel acquisition technique: a meta-analysis.
abstract: We aim to investigate the diagnostic capability of diffusion-weighted imaging using parallel acquisition technique for the differentiation between hepatic metastases and benign focal lesions with a meta-analysis. The meta-analysis included a total of 858 hepatic metastases and 440 benign liver lesions from nine studies. The pooled sensitivity and specificity of diffusion-weighted imaging (DWI) were 0.87 (95% CI, 0.84-0.89) and 0.90 (95% CI, 0.87-0.93), respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 8.50 (95% CI, 4.97-14.52) and 0.17 (95% CI, 0.11-0.26), respectively. The P value for χ (2) heterogeneity for all pooled estimates was <0.05. From the fitted summary receiver operating characteristics (SROC), the area under the curve (AUC) and Q* index were 0.95 and 0.88, respectively. Publication bias is not present (t = -0.76, P = 0.471). The meta-regression analysis indicated that evaluated covariates included patient number, patient population, mean age, maximum of b factor, number of cysts, number of hemangiomas, and field were not sources of heterogeneity (all P value >0.05). Diffusion-weighted imaging was useful for differentiation between hepatic metastases and benign focal lesions. The diffusion characteristics of the benign hepatocellular lesions, including cases of focal nodular hyperplasia (FNH) and adenoma, have rarely been reported and need further studies. The diagnostic capability of DWI with parallel acquisition technique for differentiation between metastases and benign hepatic focal lesions might be overestimated.
authors.affiliation: Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, Guangdong Province, People's Republic of China.
authors.forename: Chenggang
authors.initials: C
authors.lastname: Wei
authors.forename: Jieying
authors.initials: J
authors.lastname: Tan
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.forename: Liu
authors.initials: L
authors.lastname: Juan
authors.forename: Si Wei
authors.initials: SW
authors.lastname: Zhang
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.forename: Qun
authors.initials: Q
authors.lastname: Wang
mesh_terms: D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D039781:PubMed; D012372:ROC Curve; D011859:Radiography