A meta‑analysis of the added value of diffusion weighted imaging in combination with contrast‑enhanced magnetic resonance imaging for the diagnosis of small hepatocellular carcinoma lesser or equal to 2 cm

Lan,Hailong; Lin,Guisen; Zhong,Weizhi

doi:10.3892/ol.2020.11805

A meta‑analysis of the added value of diffusion weighted imaging in combination with contrast‑enhanced magnetic resonance imaging for the diagnosis of small hepatocellular carcinoma lesser or equal to 2 cm

Authors:
- Hailong Lan
- Guisen Lin
- Weizhi Zhong
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Affiliations: Department of Radiology, Wuchuan People's Hospital, Wuchuan, Guangdong 524500, P.R. China, Department of Radiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong 515000, P.R. China
Published online on: July 3, 2020 https://doi.org/10.3892/ol.2020.11805
Pages: 2739-2748
Copyright: © Lan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Diffusion weighted imaging (DWI) has been found to increase the sensitivity in the diagnosis of small hepatocellular carcinoma (HCC), although additional studies are required to confirm its value. The aim of the present study was to explore the diagnostic performance of DWI combined with contrast‑enhanced magnetic resonance imaging (MRI) for small HCC by performing a meta‑analysis. Literature databases (PubMed, Embase, Web of Science and Cochrane Library databases) were searched to identify studies reporting the sensitivity and specificity of MRI with DWI for the diagnosis of small HCCs. Pooled sensitivity and specificity were generated using a bivariate random effect model. Multilevel mixed‑effects logistic regression analysis was used to examine the value of DWI combined with conventional MRI. A total of 837 small HCCs and 545 benign liver lesions from 10 studies were included. The overall sensitivity and specificity of DWI combined with contrast‑enhanced MRI was 0.88 (95% CI, 0.80‑0.93) and 0.90 (95% CI, 0.81‑0.95), respectively. Compared with that in contrast‑enhanced MRI, DWI with contrast‑enhanced MRI had a significantly higher sensitivity for the diagnosis of small HCC (P=0.01) while there was no significant difference in the specificity (P=0.603). The present meta‑analysis suggests that DWI combined with contrast‑enhanced MRI may increase the sensitivity, whilst maintaining high specificity for the diagnosis of small HCCs with a diameter ≤2 cm

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