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Overall diagnostic accuracy of different MR imaging sequences for detection of dysplastic nodules: a systematic review and meta-analysis

  • Magnetic Resonance
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Abstract

Objective

To assess the overall diagnostic accuracy of different MR imaging sequences in the detection of the dysplastic nodule (DN).

Methods

PubMed, Cochrane Library, and Web of Science were systematically searched. Study selection and data extraction were conducted by two authors independently. Quality assessment of diagnostic accuracy studies (QUADAS) 2 in RevMan software was used to score the included studies and assess their methodological quality. A random-effects model was used for statistical pooling by Meta-Disc. Subgroup analysis and sensitivity analysis were used to explore potential sources of heterogeneity.

Results

Fourteen studies (335 DN lesions in total) were included in our meta-analysis. The area under the curve (AUC) of summary receiver operating characteristic (SROC) of T2WI was 0.87. Pooled sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of DWI were 0.81 (95%CI, 0.73–0.87), 0.90 (95%CI, 0.86–0.93), 7.04 (95%CI, 4.49–11.04), and 0.24 (95%CI, 0.17–0.33) respectively. In the arterial phase, pooled sensitivity, specificity, PLR, and NLR were 0.89 (0.84–0.93), 0.75 (0.72–0.79), 3.72 (2.51–5.51), and 0.17 (0.12–0.25), respectively. Pooled sensitivity, specificity, PLR, and NLR of the delayed phase were 0.78 (0.72–0.83), 0.60 (0.55–0.65), 2.19 (1.55–3.10), and 0.36 (0.23–0.55) separately. Pooled sensitivity, specificity, PLR, and NLR of the hepatobiliary phase were 0.77 (0.71–0.82), 0.92 (0.89–0.94), 8.74 (5.91–12.92), and 0.24 (0.14–0.41) respectively. Pooled sensitivity, specificity, and PLR were higher on DWI and hepatobiliary phase in diagnosing LGDN than HGDN.

Conclusion

MR sequences, particularly DWI, arterial phase, and hepatobiliary phase imaging demonstrate high diagnostic accuracy for DN.

Key Points

• MRI has dramatically improved the detection and accurate diagnosis of DNs and their differentiation from hepatocellular carcinoma.

• Overall diagnostic accuracy of different MRI sequences in the detection of DN has not been studied before.

• Our meta-analysis demonstrates that MRI achieves a high diagnostic value for DN, especially when using DWI, arterial phase imaging, and hepatobiliary phase imaging.

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Change history

  • 01 October 2021

    The term "country of origin" has been revised to "country or region of origin".

Abbreviations

CI:

Confidence interval

DN:

Dysplastic nodule

HCC:

Hepatocellular carcinoma

HGDN:

High-grade dysplastic nodule

LGDN:

Low-grade dysplasia nodules

QUADAS:

Quality assessment of diagnostic accuracy studies

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Acknowledgements

This study was funded by the General Program of National Natural Science Foundation of China, contract grant number: 30870669.

Funding

This study has received funding from the General Program of National Natural Science Foundation of China, contract grant number: 30870669.

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Authors and Affiliations

  1. Department of Radiology, The Second Hospital of Dalian Medical University, No. 467, Zhongshan Road, Shahekou District, Dalian, 116023, Liaoning Province, China

    Jingtong Xiong, Jiawen Luo & Jie Bian

  2. Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, No. 6, Jiefang Road, Zhongshan District, Dalian, 116001, Liaoning Province, China

    Jianlin Wu

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Correspondence to Jiawen Luo.

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The scientific guarantor of this publication is Jie Bian.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and Biometry

One of the authors (Jingtong Xiong) has significant statistical expertise.

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Written informed consent was not required for this study because this study belongs to meta-analysis; the data are from various published literatures.

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• multicenter study

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Xiong, J., Luo, J., Bian, J. et al. Overall diagnostic accuracy of different MR imaging sequences for detection of dysplastic nodules: a systematic review and meta-analysis. Eur Radiol 32, 1285–1296 (2022). https://doi.org/10.1007/s00330-021-08022-5

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