Dawei Yang1, Dan Li2, Jinshui Li3, Zhenghan Yang4, Zhenchang Wang5. 1. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, Beijing 100050, China. Electronic address: Dawei-yang@vip.163.com. 2. Department of Radiology, Beijing Changping Hospital, Beijing 102200, China. Electronic address: 916900015@qq.com. 3. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address: 741123534@qq.com. 4. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address: Zhenghanyang@263.net. 5. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address: cjr.wzhch@vip.163.com.
Abstract
PURPOSE: To evaluate the diagnostic efficacy of gadoxetic acid-enhanced MRI for the staging of liver fibrosis by meta-analysis. METHODS: PubMed/Medline, EMBASE, the Web of Science, and the Cochrane Library were searched. Studies were included according to their eligibility and the exclusion criteria. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the methodologic quality. The bivariate random-effects model was used to obtain the pooled summary estimates, heterogeneity, and the area under summary receiver operating characteristic curves (AUROC). Meta-regression was performed to discover the source of heterogeneity and compare certain some subsets for their capacity to stage hepatic fibrosis by AUROC comparison. RESULTS: A total of 20 original articles (1936 patients) were included. Most studies had a low risk of bias and minimal concerns regarding applicability. The summary AUROC values of gadoxetic acid-enhanced MRI in staging the liver fibrosis ≥ F1, ≥ F2, ≥ F3, and F4 subsets were 0.92, 0.87, 0.89, and 0.91, respectively. Studies with populations equal to or more than 100 had a significantly higher sensitivity (84 %) and specificity (91 %) than those with populations less than 100 (70 % and 77 %, respectively, P < 0.01). Studies of a prospective design exhibited a significantly higher sensitivity (94 %) and specificity (94 %) than those of a retrospective design (75 % and 84 %, respectively, P < 0.01). CONCLUSIONS: Our meta-analysis shows the high diagnostic efficacy of gadoxetic acid-enhanced MRI in the staging of liver fibrosis. A prospective study with more than one hundred patients showed higher diagnostic efficacy.
PURPOSE: To evaluate the diagnostic efficacy of gadoxetic acid-enhanced MRI for the staging of liver fibrosis by meta-analysis. METHODS: PubMed/Medline, EMBASE, the Web of Science, and the Cochrane Library were searched. Studies were included according to their eligibility and the exclusion criteria. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the methodologic quality. The bivariate random-effects model was used to obtain the pooled summary estimates, heterogeneity, and the area under summary receiver operating characteristic curves (AUROC). Meta-regression was performed to discover the source of heterogeneity and compare certain some subsets for their capacity to stage hepatic fibrosis by AUROC comparison. RESULTS: A total of 20 original articles (1936 patients) were included. Most studies had a low risk of bias and minimal concerns regarding applicability. The summary AUROC values of gadoxetic acid-enhanced MRI in staging the liver fibrosis ≥ F1, ≥ F2, ≥ F3, and F4 subsets were 0.92, 0.87, 0.89, and 0.91, respectively. Studies with populations equal to or more than 100 had a significantly higher sensitivity (84 %) and specificity (91 %) than those with populations less than 100 (70 % and 77 %, respectively, P < 0.01). Studies of a prospective design exhibited a significantly higher sensitivity (94 %) and specificity (94 %) than those of a retrospective design (75 % and 84 %, respectively, P < 0.01). CONCLUSIONS: Our meta-analysis shows the high diagnostic efficacy of gadoxetic acid-enhanced MRI in the staging of liver fibrosis. A prospective study with more than one hundred patients showed higher diagnostic efficacy.