Contrast-enhanced ultrasound for the characterization of portal vein thrombosis vs tumor-in-vein in HCC patients: a systematic review and meta-analysis.
Eur Radiol
; 30(5): 2871-2880, 2020 May.
Article
in En
| MEDLINE
| ID: mdl-32020403
ABSTRACT
OBJECTIVES:
Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. However, differentiation of thrombosis and tumor-in-vein (TIV) may be challenging. Contrast-enhanced ultrasound (CEUS) is an excellent method for detection of vascularization and could help in the distinction. We performed a systematic review and meta-analysis for evaluating the diagnostic value of CEUS in differentiating between PVT and TIV in hepatocellular carcinoma (HCC) patients.METHODS:
PubMed, Embase, Cochrane Library, and Web of Science were searched up to the 5th of May 2019. The study quality was assessed by QUADAS-2 tool. Pooled sensitivity and specificity were calculated by the bivariate random effect model and hierarchical summary receiver-operating characteristic (SROC) curve was plotted.RESULTS:
Seven studies including 425 participants were analyzed after screening 986 articles searched from databases. The pooled sensitivity and specificity of CEUS in diagnosing TIV were 0.94 (95%CI, 0.89-0.97) and 0.99 (95%CI, 0.80-1.00), respectively. The area under the curve (AUC) of SROC curve was 0.97 (95%CI, 0.95-0.98). The pooled sensitivity and AUC were consistent across all the subgroups of different subject numbers, country, study design, CEUS contrast agents, and diagnostic criteria.CONCLUSIONS:
CEUS is highly efficient in differentiating TIV from PVT and is an alternative or a substitute for CT and/or MRI. TRIAL REGISTRATION PROSPERO registration number CRD42019138847 KEY POINTS ⢠Characterization of portal vein thrombosis (PVT) vs tumor-in-vein (TIV) is critical for HCC staging. ⢠CEUS has an excellent safety profile, provides a real-time analysis without any loss in accuracy compared with CT and MRI. ⢠This meta-analysis demonstrates that contrast-enhanced ultrasound (CEUS) is a suitable method for the detection of PVT and distinction with TIV.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Portal Vein
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Image Enhancement
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Ultrasonography
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Carcinoma, Hepatocellular
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Contrast Media
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Venous Thrombosis
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Liver Neoplasms
Type of study:
Diagnostic_studies
/
Prognostic_studies
/
Systematic_reviews
Limits:
Female
/
Humans
Language:
En
Journal:
Eur Radiol
Journal subject:
RADIOLOGIA
Year:
2020
Type:
Article
Affiliation country:
China