A pooled analysis of diffusion-weighted imaging in the diagnosis of hepatocellular carcinoma in chronic liver diseases.

Background and Aim The purpose of this study was to perform a meta-analysis of all available studies of the diagnostic performance of diffusion-weighted imaging (DWI) in the detection of hepatocellular carcinoma (HCC) in patients with chronic liver disease. Methods Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 2000 to April 2012. Pooled estimation and subgroup analysis data were obtained by statistical analysis. Results Across the nine studies (476 patients), DWI sensitivity was 81% (95%CI: 67%90%), and specificity was 89% (95% CI: 76%95%). Overall, positive likelihood ratio was 7.11 (95%CI: 3.50, 14.48), negative likelihood ratio was 0.21 (95%CI: 0.120.37), and the diagnostic odds ratio (DOR) was 33.48 (95%CI: 16.6767.25). The area under the curve of the summary receiver operator characteristic (ROC) was 0.92 (95% CI:0.890.94). In studies in which both DWI and conventional contrast-enhanced magnetic resonance imaging (CE-MRI) were performed, the comparison of DWI performance with that of conventional CE-MRI suggested no major differences against these two methods (P?>?0.05). DWI combined CE-MRI had higher pooled sensitivity than DWI alone (93% vs 73%) (P?更多