CEUS compared with CECT, MRI, and FDG-PET/CT for diagnosing CRC liver metastases: a diagnostic test accuracy systematic review and meta-analysis.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Expert Review of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-09-25 DOI:10.1080/17474124.2024.2407973

Martin Lund, Thomas A Bjerre, Henning Grønbæk, Frank V Mortensen, Per Kragh Andersen

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Abstract

Objective: To determine the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) compared with contrast-enhanced computed tomography (CECT), magnetic resonance imaging (MRI), and Fluorine-18-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for diagnosing suspected liver metastases in patients with newly diagnosed colorectal cancer (CRC).

Methods: The meta-analysis using the bivariate model included studies on patients with newly diagnosed CRC only and excluded patients with non-CRC liver metastases, known liver metastases, patients treated with chemotherapy and local treatments, e.g. hepatic resection or radiofrequency ablation. We used QUADAS-2 to assess the methodological quality of the studies.

Results: We included 32 studies, 6 studies evaluated the accuracy of CEUS (n = 937 participants), 26 studies evaluated CECT (n = 2,582), 8 studies evaluated MRI (n = 564) and 6 studies evaluated FDG-PET/CT (n = 813). Sensitivity: FDG-PET/CT 94.4% [95% CI: 90.7-98.1%], MRI 92.9% [95% CI: 88.8-97.0%], CEUS 86.1% [95% CI: 78.0-94.3%] and CECT 84.6% [95% CI: 79.3-89.9%]. Specificity FDG-PET/CT 97.9% [95% CI: 95.9-99.9%], CEUS 96.1% [95% CI: 93.6-98.6%], MRI 94.4% [95% CI: 90.5-98.3%], and CECT 94.3% [95% CI: 91.8-96.8%].

Conclusion: FDG-PET/CT had significantly higher sensitivity and specificity than CECT, and significantly higher sensitivity than CEUS. MRI had a significantly higher sensitivity than CEUS, but a lower non-significant specificity. CECT had the lowest sensitivity and specificity.

Prospero registration details: CRD42017055015 and CRD42017082996.

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CEUS与CECT、MRI和FDG-PET/CT诊断CRC肝转移的比较：诊断测试准确性系统回顾和荟萃分析。

目的确定对比增强超声（CEUS）与对比增强计算机断层扫描（CECT）、磁共振成像（MRI）和氟-18-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）相比，在诊断新诊断结直肠癌（CRC）患者疑似肝转移方面的诊断准确性：使用双变量模型进行的荟萃分析只包括对新诊断的 CRC 患者的研究，不包括非 CRC 肝转移患者、已知肝转移患者、接受化疗、肝切除或射频消融等局部治疗的患者。我们使用 QUADAS-2 评估研究的方法学质量：我们纳入了 32 项研究，其中 6 项研究评估了 CEUS 的准确性（n = 937 名参与者），26 项研究评估了 CECT 的准确性（n = 2,582 名参与者），8 项研究评估了 MRI 的准确性（n = 564 名参与者），6 项研究评估了 FDG-PET/CT 的准确性（n = 813 名参与者）。灵敏度FDG-PET/CT 94.4% [95% CI：90.7-98.1%]、MRI 92.9% [95% CI：88.8-97.0%]、CEUS 86.1% [95% CI：78.0-94.3%] 和 CECT 84.6% [95% CI：79.3-89.9%]：特异性：FDG-PET/CT 97.9% [95% CI：95.9-99.9%]、CEUS 96.1% [95% CI：93.6-98.6%]、MRI 94.4% [95% CI：90.5-98.3%] 和 CECT 94.3% [95% CI：91.8-96.8%]：结论：FDG-PET/CT的敏感性和特异性明显高于CECT，明显高于CEUS。磁共振成像的敏感性明显高于 CEUS，但特异性较低，不明显。CECT的敏感性和特异性最低：CRD42017055015和CRD42017082996。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.