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Diagnostic performance of MRI for residual or recurrent hepatocellular carcinoma after locoregional treatment according to contrast agent type: a systematic review and meta‑analysis

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Abstract

Purpose

The ideal contrast agent for imaging patients with hepatocellular carcinoma (HCC) following locoregional therapies (LRT) remains uncertain. We conducted a meta-analysis to assess the diagnostic performance of magnetic resonance imaging with extracellular contrast agent (ECA-MRI) and hepatobiliary agent (EOB-MRI) in detecting residual or recurrence HCC following LRT.

Methods

Original studies comparing the diagnostic performance of ECA-MRI and EOB-MRI were systematically identified through comprehensive searches in PubMed, EMBASE, Cochrane Library and Web of Science databases. The pooled sensitivity and specificity of ECA-MRI and EOB-MRI were calculated using a bivariate-random-effects model. Subgroup-analyses were conducted to compare the diagnostic performance of ECA-MRI and EOB-MRI according to different variables. Meta-regression analysis was employed to explore potential sources of study heterogeneity.

Results

A total of 15 eligible studies encompassing 803 patients and 1018 lesions were included. Comparative analysis revealed no significant difference between ECA-MRI and EOB-MRI in the overall pooled sensitivity (87% vs. 79%) and specificity (92% vs. 96%) for the detection of residual or recurrent HCC after LRT (P = 0.41), with comparable areas under the HSROC of 0.95 and 0.92. Subgroup analyses indicated no significant diagnostic performance differences between ECA-MRI and EOB-MRI according to study design, type of LRT, most common etiology of liver disease, baseline lesion size, time of post-treated examination and MRI field strength (All P > 0.05).

Conclusion

ECA-MRI exhibited overall comparable diagnostic performance to EOB-MRI in assessing residual or recurrent HCC after LRT.

Graphical abstract

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Abbreviations

HCC:

Hepatocellular carcinoma

LRT:

Locoregional therapies

ECA:

Extracellular contrast agent

EOB:

Hepatobiliary agent

TACE:

Transarterial chemoembolization

HBP:

Hepatobiliary phase

LI-RADS:

Liver Reporting and Data System

DSA:

Digital subtraction angiography

HSROC:

Hierarchical summary receiver operating characteristic

AUC:

Area under the curve

RFA:

Radiofrequency ablation

BCLC:

Barcelona Clinic Liver Cancer

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Funding

This work was supported by National Natural Science Foundation of China (NSFC, Grant Nos 82271978 and 81801669) and the Key Research and Development Program of Jiangsu Province (BE2020717).

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Authors and Affiliations

  1. Department of Radiology, Zhongda Hospital, Jiangsu Key Laboratory of Molecular and Functional Imaging, School of Medicine, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, China

    Shuwei Zhou, Weilang Wang, Shuhang Zhang, Noble Chibuike Opara, Shenghong Ju, Ying Cui & Yuan-Cheng Wang

  2. Department of Gastroenterology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha, 410007, Hunan, China

    Siyu Wang

  3. Department of Radiology, The First Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha, 410007, Hunan, China

    Jian Xiang

  4. School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, 610000, China

    Zhongyu Han

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  1. Shuwei Zhou
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Zhou, S., Wang, S., Xiang, J. et al. Diagnostic performance of MRI for residual or recurrent hepatocellular carcinoma after locoregional treatment according to contrast agent type: a systematic review and meta‑analysis. Abdom Radiol 49, 471–483 (2024). https://doi.org/10.1007/s00261-023-04143-1

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