Literature DB >> 23432804

Contrast-Enhanced Ultrasound for the differentiation of benign and malignant focal liver lesions: a meta-analysis.

Mireen Friedrich-Rust1, Tom Klopffleisch, Julia Nierhoff, Eva Herrmann, Johannes Vermehren, Maximilian D Schneider, Stefan Zeuzem, Joerg Bojunga.   

Abstract

BACKGROUND: International guidelines of Ultrasound recommend the performance of contrast-enhanced ultrasound (CEUS) as the first method of choice after conventional ultrasound for the diagnostic work-up of focal liver lesions. However, these recommendations are based on the results of multiple single studies and only few large multicentre studies. AIMS: The rationale of the present systematic review and meta-analysis was to assess the overall sensitivity and specificity of CEUS for the diagnosis of malignant liver lesions.
METHODS: Literature databases were searched up to March 2012. Inclusion criteria were evaluation of CEUS, assessment of sensitivity and specificity of CEUS for the diagnosis of malignant liver lesions. The meta-analysis was performed using the random-effects model based on the DerSimonian Laird method. Quality analyses were carried out to assess sources of heterogeneity.
RESULTS: A total of 45 studies with 8147 focal liver lesions were included in the analysis. Overall sensitivity and specificity of CEUS for the diagnosis of malignant liver lesions was 93% (95%-CI: 91-95%) and 90% (95%-CI: 88-92%) respectively. Significant heterogeneity was found between studies. However, subanalysis revealed no significant difference when evaluating studies using histology for all liver lesions, when comparing high-quality and low-quality studies, and blinded vs non-blinded studies.
CONCLUSION: The results of this meta-analysis support the international recommendations on CEUS for the diagnostic work-up of focal liver lesions selecting patients who need further diagnostics.
© 2013 John Wiley & Sons A/S.

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Year:  2013        PMID: 23432804     DOI: 10.1111/liv.12115

Source DB:  PubMed          Journal:  Liver Int        ISSN: 1478-3223            Impact factor:   5.828


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