title: Superparamagnetic iron oxide-enhanced magnetic resonance imaging for focal hepatic lesions: systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the performance of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) in the detection and characterization of focal hepatic lesions (FHLs).
  
  
  METHODS
  This meta-analysis compared relevant studies that were identified by searching PubMed, EMBASE, and the Cochrane Library databases for articles published between January 1988 and September 2014 and that met the following criteria: (1) SPIO-enhanced MRI was conducted to identify FHLs and data were sufficient for pooled analysis using Meta-DiSc 1.4; (2) hepatocellular carcinomas (HCCs) were differentiated from other FHLs; (3) well-differentiated HCCs (WD-HCCs) were contradistinguished from dysplastic nodules; and (4) WD-HCCs were compared with moderately and poorly differentiated HCCs (MD- and PD-HCCs, respectively).
  
  
  RESULTS
  The data obtained from 15 eligible studies yielded a sensitivity of 85% and a specificity of 78% for differentiating between HCCs and other FHLs. The sensitivity was unchanged and the specificity was increased to 87% when non-HCC malignancies were excluded. Comparative analyses between WD-HCCs and MD- and PD-HCCs from seven studies showed a sensitivity of 98% and a specificity of 50% for the diagnosis of MD- and PD-HCCs, and the area under the summary receiver operating characteristics (sROC) curve was 0.97. A comparison between WD-HCCs and dysplastic nodules revealed a sensitivity of 50% and a specificity of 92% for the diagnosis of WD-HCCs and the area under the sROC curve was 0.80.
  
  
  CONCLUSIONS
  SPIO-enhanced MRI is useful in differentiating between HCCs and other FHLs.
authors.affiliation: You-Wei Li, Department of Radiology, Beijing Chuiyangliu Hospital Affiliated to School of Medicine, Tsinghua University, Beijing 100022, China.
authors.forename: You-Wei
authors.initials: YW
authors.lastname: Li
authors.affiliation: You-Wei Li, Department of Radiology, Beijing Chuiyangliu Hospital Affiliated to School of Medicine, Tsinghua University, Beijing 100022, China.
authors.forename: Zheng-Guang
authors.initials: ZG
authors.lastname: Chen
authors.affiliation: You-Wei Li, Department of Radiology, Beijing Chuiyangliu Hospital Affiliated to School of Medicine, Tsinghua University, Beijing 100022, China.
authors.forename: Ji-Chen
authors.initials: JC
authors.lastname: Wang
authors.affiliation: You-Wei Li, Department of Radiology, Beijing Chuiyangliu Hospital Affiliated to School of Medicine, Tsinghua University, Beijing 100022, China.
authors.forename: Zong-Ming
authors.initials: ZM
authors.lastname: Zhang
mesh_terms: D019540:Area Under Curve; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D003287:Contrast Media; D003911:Dextrans; D003937:Diagnosis, Differential; D020518:Focal Nodular Hyperplasia / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; C065507:ferumoxides
keywords: Hepatocellular carcinomas; Magnetic resonance imaging; Meta-analysis; Other lesions; USPIO