Diagnostic performance of contrast-enhanced multidetector computed tomography and gadoxetic acid disodium-enhanced magnetic resonance imaging in detecting hepatocellular carcinoma: direct comparison and a meta-analysis.
The purpose of this study was to directly (head-to-head) compare the per-lesion diagnostic performance of contrast-enhanced computed tomography (CT) (also referred to as CT hereafter) and gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging (also referred to as MRI hereafter) for the detection of hepatocellular carcinoma (HCC). Studies reporting direct per-lesion comparison data of contrast-enhanced multidetector CT and Gd-EOB-DTPA-enhanced MR imaging that were published between January 2000 and January 2015 were analyzed. The data of each study were extracted. Systematic review, paired meta-analysis, and subgroup analysis were performed. Twelve studies including 627 patients and 793 HCC lesions were analyzed. The sensitivity estimates of MRI and CT were, respectively, 0.86 (95% CI 0.76-0.93) and 0.70 (95% CI 0.58-0.80), with significant difference (P < 0.05). The sensitivity estimates were both 0.94 (95% CI 0.92-0.96) (Chi-square 4.84, degrees of freedom = 1, P > 0.05). In all subgroups, Gd-EOB-DTPA-enhanced MR imaging was more sensitive than multidetector CT for the detection of HCC, and specificity estimates of both tests maintained at a similarly high level in all conditions: sensitivity estimates of both tests were reduced in studies where patients were diagnosed with HCC solely by liver explant or in those where HCC lesions were small (≤2 cm, especially when ≤1 cm). But in all situations, sensitivities of MRI were higher than those of CT with or without significance. Gd-EOB-DTPA-enhanced MR imaging showed better per-lesion diagnostic performance than multidetector CT for the diagnosis of HCC in patients with cirrhosis and in small hepatic lesions.
Department of Anesthesia, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
Jin
J
Guo
Department of Medical Biotechnology, Dongguk University, Seoul, Korea.
Youngkwon
Y
Seo
Department of Medical Biotechnology, Dongguk University, Seoul, Korea.
Shuo
S
Ren
Department of Chemistry, Sungkyunkwan University, Suwon, Korea.
Sunwoo
S
Hong
Department of Chemistry, Sungkyunkwan University, Suwon, Korea.
Dongki
D
Lee
Department of Medical Biotechnology, Dongguk University, Seoul, Korea.
Soyoun
S
Kim
Department of Medical Biotechnology, Dongguk University, Seoul, Korea. jiangyuanyuan@dongguk.edu.
Yuanyuan
Y
Jiang
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D061330:Multidetector Computed Tomography
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
Computed tomography; Diagnosis; Gadoxetic acid disodium-enhanced magnetic resonance imaging; Hepatocellular carcinoma; Meta-analysis