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

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). 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, local treatments e.g. hepatic resection or radiofrequency ablation. We used QUADAS-2 to assess the methodological quality of the studies. We included 32 studies, 6 studies evaluated the accuracy of CEUS (<i>n</i> = 937 participants), 26 studies evaluated CECT (<i>n</i> = 2,582), 8 studies evaluated MRI (<i>n</i> = 564) and 6 studies evaluated FDG-PET/CT (<i>n</i> = 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%]. 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%]. 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. CRD42017055015 and CRD42017082996.

本研究旨在评估对比增强超声（contrast-enhanced ultrasound, CEUS）、对比增强计算机断层扫描（contrast-enhanced computed tomography, CECT）、磁共振成像（magnetic resonance imaging, MRI）及氟-18-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（Fluorine-18-deoxyglucose positron emission tomography/computed tomography, FDG-PET/CT），对初诊结直肠癌（colorectal cancer, CRC）患者疑似肝转移的诊断准确性。本研究采用双变量模型开展荟萃分析，纳入仅针对初诊CRC患者的相关研究，排除合并非CRC肝转移、已知存在肝转移、接受过化疗或局部治疗（如肝切除术、射频消融术）的患者。我们采用QUADAS-2工具对纳入研究的方法学质量进行评估。本研究共纳入32项相关研究：其中6项评估CEUS的诊断准确性（受试者例数n=937），26项评估CECT（n=2582），8项评估MRI（n=564），6项评估FDG-PET/CT（n=813）。敏感性方面：FDG-PET/CT为94.4%[95%CI：90.7%~98.1%]，MRI为92.9%[95%CI：88.8%~97.0%]，CEUS为86.1%[95%CI：78.0%~94.3%]，CECT为84.6%[95%CI：79.3%~89.9%]。特异性方面：FDG-PET/CT为97.9%[95%CI：95.9%~99.9%]，CEUS为96.1%[95%CI：93.6%~98.6%]，MRI为94.4%[95%CI：90.5%~98.3%]，CECT为94.3%[95%CI：91.8%~96.8%]。分析结果显示，FDG-PET/CT的敏感性与特异性均显著高于CECT，且敏感性显著高于CEUS；MRI的敏感性显著高于CEUS，但特异性略低且差异无统计学意义。CECT的敏感性与特异性均为本次研究中最低。本研究注册编号为CRD42017055015与CRD42017082996。

搜集汇总

背景与挑战

背景概述

该数据集是一个关于对比增强超声（CEUS）与其他影像学技术（CECT、MRI、FDG-PET/CT）在诊断结直肠癌肝转移方面准确性的系统综述和荟萃分析。研究结果显示，FDG-PET/CT在敏感性和特异性方面表现最佳，而CECT的敏感性和特异性最低。