Farhad Nalaini1, Fatemeh Shahbazi2, Seyedeh Maryam Mousavinezhad3, Ali Ansari4, Mohammadgharib Salehi1. 1. Department of Radiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 4. Department of Mathematics, K. N. Toosi University of Technology, Tehran, Iran.
Abstract
OBJECTIVES: We undertook a systematic review and meta-analysis of the diagnostic performance of mean apparent diffusion coefficient (ADC) values derived by diffusion-weighted (DW)-MRI in the characterization of solid benign and malignant liver lesions, and to assess their value in discriminating these lesions in daily routine practice. METHODS: A systematic review of PubMed, Embase, Scopus, and Web of Science was conducted to retrieve studies that used ADC values for differentiating solid benign/dysplastic nodules and malignant liver lesions. A bivariate random-effects model with pooled sensitivity and specificity values with 95% CI (confidence interval) was used. This meta-analysis was performed on the per-lesion basis. Summary receiver operating characteristic (SROC) plot and area under curve (AUC) were created. RESULTS: A total of 14 original articles were retrieved. The combined (95% CI) sensitivity and specificity of mean ADC values for differentiating solid benign from malignant lesions were 78% (67-86%) and 74% (64-81%), respectively. The pooled (95% CI) positive and negative LRs were respectively 3 (2.3-3.8) and 0.3 (0.21-0.43). The DOR (95% CI) was 10 (7-15). The AUC (95% CI) of the SROC plot was 82% (78-85%). Reporting bias was negligible (p value of regression test = 0.36). Mean size of malignant lesions and breathing pattern of MRI were found to be sources of heterogeneity of pooled sensitivity. CONCLUSION: ADC measurement independently may not be an optimal diagnostic imaging method for differentiating solid malignant from solid benign hepatic lesions. The meta-analysis showed that ADC measurement had moderate diagnostic accuracy for characterizing solid liver lesions. Further prospective and comparative studies with pre-specified ADC thresholds could be performed to investigate the best MRI protocol and ADC threshold for characterizing solid liver lesions. ADVANCES IN KNOWLEDGE: ADC measurement by DW-MRI does not have a good diagnostic performance to differentiate solid malignant from solid benign lesions. Therefore, we suggest not using ADC values in clinical practice to evaluate solid liver lesions.
OBJECTIVES: We undertook a systematic review and meta-analysis of the diagnostic performance of mean apparent diffusion coefficient (ADC) values derived by diffusion-weighted (DW)-MRI in the characterization of solid benign and malignant liver lesions, and to assess their value in discriminating these lesions in daily routine practice. METHODS: A systematic review of PubMed, Embase, Scopus, and Web of Science was conducted to retrieve studies that used ADC values for differentiating solid benign/dysplastic nodules and malignant liver lesions. A bivariate random-effects model with pooled sensitivity and specificity values with 95% CI (confidence interval) was used. This meta-analysis was performed on the per-lesion basis. Summary receiver operating characteristic (SROC) plot and area under curve (AUC) were created. RESULTS: A total of 14 original articles were retrieved. The combined (95% CI) sensitivity and specificity of mean ADC values for differentiating solid benign from malignant lesions were 78% (67-86%) and 74% (64-81%), respectively. The pooled (95% CI) positive and negative LRs were respectively 3 (2.3-3.8) and 0.3 (0.21-0.43). The DOR (95% CI) was 10 (7-15). The AUC (95% CI) of the SROC plot was 82% (78-85%). Reporting bias was negligible (p value of regression test = 0.36). Mean size of malignant lesions and breathing pattern of MRI were found to be sources of heterogeneity of pooled sensitivity. CONCLUSION: ADC measurement independently may not be an optimal diagnostic imaging method for differentiating solid malignant from solid benign hepatic lesions. The meta-analysis showed that ADC measurement had moderate diagnostic accuracy for characterizing solid liver lesions. Further prospective and comparative studies with pre-specified ADC thresholds could be performed to investigate the best MRI protocol and ADC threshold for characterizing solid liver lesions. ADVANCES IN KNOWLEDGE: ADC measurement by DW-MRI does not have a good diagnostic performance to differentiate solid malignant from solid benign lesions. Therefore, we suggest not using ADC values in clinical practice to evaluate solid liver lesions.
Authors: Gehad A Saleh; Ali H Elmokadem; Ahmed Abdel Razek; Ahmed El-Morsy; Omar Hamdy; Elshimaa S Eleraky; Marwa Saleh Journal: Eur Radiol Date: 2022-08-18 Impact factor: 7.034
Authors: Nandita M deSouza; Aad van der Lugt; Christophe M Deroose; Angel Alberich-Bayarri; Luc Bidaut; Laure Fournier; Lena Costaridou; Daniela E Oprea-Lager; Elmar Kotter; Marion Smits; Marius E Mayerhoefer; Ronald Boellaard; Anna Caroli; Lioe-Fee de Geus-Oei; Wolfgang G Kunz; Edwin H Oei; Frederic Lecouvet; Manuela Franca; Christian Loewe; Egesta Lopci; Caroline Caramella; Anders Persson; Xavier Golay; Marc Dewey; James P B O'Connor; Pim deGraaf; Sergios Gatidis; Gudrun Zahlmann Journal: Insights Imaging Date: 2022-10-04