局部治疗后LI-RADS治疗反应与改良RECIST诊断活肝细胞癌:比较研究的系统回顾和荟萃分析。

Taehan Yongsang Uihakhoe chi Pub Date : 2022-03-01 Epub Date: 2022-02-25 DOI:10.3348/jksr.2021.0173
Dong Hwan Kim, Bohyun Kim, Joon-Il Choi, Soon Nam Oh, Sung Eun Rha
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引用次数: 2

摘要

目的:系统比较肝脏影像学报告和数据系统治疗反应(LR-TR)与修订后的实体肿瘤反应评价标准(mRECIST)在诊断经局部治疗(LRT)的活肝细胞癌(HCC)中的表现。材料和方法:截至2021年8月25日,在MEDLINE和EMBASE中检索了使用动态对比增强CT或MRI对LR-TR和mRECIST诊断性能进行个体内比较的原始研究。肿瘤生存的参照标准为手术病理。使用双变量随机效应模型计算每个标准可行类别的meta分析合并敏感性和特异性,并使用双变量meta回归进行比较。结果:在5项符合条件的研究中(430例患者,631例治疗观察),LR-TR可行类别的合并病灶敏感性和特异性分别为58%(95%置信区间[CI], 45%-70%)和93% (95% CI, 88%-96%), mRECIST可行类别的合并病灶敏感性和特异性分别为56% (95% CI, 42%-69%)和86% (95% CI, 72%-94%)。LR-TR活菌分类的合并特异性显著高于mRECIST (p < 0.01),但合并敏感性相当(p = 0.53)。结论:LR-TR算法比mRECIST具有更好的特异性,对LRT后病理存活HCC的诊断敏感性无显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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LI-RADS Treatment Response versus Modified RECIST for Diagnosing Viable Hepatocellular Carcinoma after Locoregional Therapy: A Systematic Review and Meta-Analysis of Comparative Studies.

Purpose: To systematically compare the performance of liver imaging reporting and data system treatment response (LR-TR) with the modified Response Evaluation Criteria in Solid Tumors (mRECIST) for diagnosing viable hepatocellular carcinoma (HCC) treated with locoregional therapy (LRT).

Materials and methods: Original studies of intra-individual comparisons between the diagnostic performance of LR-TR and mRECIST using dynamic contrast-enhanced CT or MRI were searched in MEDLINE and EMBASE, up to August 25, 2021. The reference standard for tumor viability was surgical pathology. The meta-analytic pooled sensitivity and specificity of the viable category using each criterion were calculated using a bivariate random-effects model and compared using bivariate meta-regression.

Results: For five eligible studies (430 patients with 631 treated observations), the pooled per-lesion sensitivities and specificities were 58% (95% confidence interval [CI], 45%-70%) and 93% (95% CI, 88%-96%) for the LR-TR viable category and 56% (95% CI, 42%-69%) and 86% (95% CI, 72%-94%) for the mRECIST viable category, respectively. The LR-TR viable category provided significantly higher pooled specificity (p < 0.01) than the mRECIST but comparable pooled sensitivity (p = 0.53).

Conclusion: The LR-TR algorithm demonstrated better specificity than mRECIST, without a significant difference in sensitivity for the diagnosis of pathologically viable HCC after LRT.

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