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The diagnostic performance of contrast-enhanced CT versus extracellular contrast agent-enhanced MRI in detecting hepatocellular carcinoma: direct comparison and a meta-analysis

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Abstract

To compare the diagnostic value of contrast-enhanced computed tomography (CT) with extracellular contrast agent-enhanced magnetic resonance imaging (ECA-MRI) for the detection of hepatocellular carcinoma (HCC). Pubmed, Embase, Web of Science and Cochrane Library were searched (1/5/2021) for studies comparing contrast-enhanced CT with ECA-MRI in patients suspected of HCC. Studies without head-to-head comparison were excluded. The pooled sensitivity, specificity and summary area under the curve (sAUC) of contrast-enhanced CT and ECA-MRI in detecting HCC was calculated based on bivariate random effects model. Heterogeneity test included threshold effect analysis and meta-regression. Subgroup analyses were conducted according to lesion size (< 20 mm or ≥ 20 mm). Overall, 10 articles containing 1333 patients were deemed suitable for inclusion in this meta-analysis. ECA-MRI displayed increased sensitivity to contrast-enhanced CT in detecting HCC (0.77 vs. 0.63, P < 0.01). The difference in specificity between ECA-MRI and contrast-enhanced CT was not statistically significant (0.93 vs. 0.94, P = 0.25). ECA-MRI yielded higher diagnostic accuracy (sAUCs = 0.88 vs. 0.80, P < 0.01). In the subgroup analysis with a lesion size < 20 mm, ECA-MRI allowed significant gains of accuracy compared to contrast-enhanced CT (0.79 vs. 0.72, P = 0.02). ECA-MRI also outperformed contrast-enhanced CT in patients with lesion size ≥ 20 mm (sAUCs = 0.96 vs. 0.93, P = 0.04). ECA-MRI provided higher sensitivity and accuracy than contrast-enhanced CT in detecting HCC, especially lesions size < 20 mm.

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The data used to support the findings of this study are available from the author upon reasonable request.

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Funding

The authors state that this study has received funding by National Natural Science Foundation of China Grant 91959118 (JW), Clinical Research Foundation of the 3rd Affiliated Hospital of Sun Yat-Sen University YHJH201901 (JW), Key Research and Development Program of Guangdong Province 2019B020235002 (JW) and Guangdong Basic and Applied Basic Research Foundation of China Grant 2021A1515010582 (JW).

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Author notes

  1. Xi Chen and Mingkai Li contributed equally to the study concept and design, acquisition of data, statistical analysis, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.

Authors and Affiliations

  1. Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University (SYSU), No 600, Tianhe Road, Guangzhou, 510630, Guangdong, People’s Republic of China

    Xi Chen, Ruomi Guo, Weimin Liu, Jianwen Li, Xiaodan Zong, Qilong Chen & Jin Wang

  2. Department of Gastroenterology, The Third Affiliated Hospital, Sun Yat-Sen University (SYSU), No 600, Tianhe Road, Guangzhou, 510630, Guangdong, People’s Republic of China

    Mingkai Li

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  1. Xi Chen
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Contributions

Literature search and data extraction were mainly performed by XC and ML. RG helped to conduct study quality assessment. XC and ML performed the study design and data analysis. ML, XC and WL drafted the manuscript. JL, XZ and QC helped to revise the manuscript. JW supervised the study. All authors read and approved the final manuscript. I would like to declare on behalf of my co-authors that the work described was original study that has not been published previously. All the authors listed have approved the manuscript that is enclosed.

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Correspondence to Jin Wang.

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Chen, X., Li, M., Guo, R. et al. The diagnostic performance of contrast-enhanced CT versus extracellular contrast agent-enhanced MRI in detecting hepatocellular carcinoma: direct comparison and a meta-analysis. Abdom Radiol 47, 2057–2070 (2022). https://doi.org/10.1007/s00261-022-03484-7

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