Diagnostic accuracy of apparent diffusion coefficient (ADC) value in differentiating malignant from benign solid liver lesions: a systematic review and meta-analysis

British Journal of Radiology - Tập 94 Số 1123 - 2021
Farhad Nalaini1, Fatemeh Shahbazi2, Seyedeh Maryam Mousavinezhad3, Ali Ansari4, Mohammadgharib Salehi1
1Department of Radiology, School of Medicine, Kermanshah University of Medical Sciences , Kermanshah , Iran
2School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4Department of Mathematics, K. N. Toosi University of Technology, Tehran, Iran

Tóm tắt

Objectives: We undertook a systematic review and meta-analysis of the diagnostic performance of mean apparent diffusion coefficient (ADC) values derived by diffusion-weighted (DW)-MRI in the characterization of solid benign and malignant liver lesions, and to assess their value in discriminating these lesions in daily routine practice. Methods: A systematic review of PubMed, Embase, Scopus, and Web of Science was conducted to retrieve studies that used ADC values for differentiating solid benign/dysplastic nodules and malignant liver lesions. A bivariate random-effects model with pooled sensitivity and specificity values with 95% CI (confidence interval) was used. This meta-analysis was performed on the per-lesion basis. Summary receiver operating characteristic (SROC) plot and area under curve (AUC) were created. Results: A total of 14 original articles were retrieved. The combined (95% CI) sensitivity and specificity of mean ADC values for differentiating solid benign from malignant lesions were 78% (67–86%) and 74% (64–81%), respectively. The pooled (95% CI) positive and negative LRs were respectively 3 (2.3–3.8) and 0.3 (0.21–0.43). The DOR (95% CI) was 10 (7–15). The AUC (95% CI) of the SROC plot was 82% (78–85%). Reporting bias was negligible (p value of regression test = 0.36). Mean size of malignant lesions and breathing pattern of MRI were found to be sources of heterogeneity of pooled sensitivity. Conclusion: ADC measurement independently may not be an optimal diagnostic imaging method for differentiating solid malignant from solid benign hepatic lesions. The meta-analysis showed that ADC measurement had moderate diagnostic accuracy for characterizing solid liver lesions. Further prospective and comparative studies with pre-specified ADC thresholds could be performed to investigate the best MRI protocol and ADC threshold for characterizing solid liver lesions. Advances in knowledge: ADC measurement by DW-MRI does not have a good diagnostic performance to differentiate solid malignant from solid benign lesions. Therefore, we suggest not using ADC values in clinical practice to evaluate solid liver lesions.

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British Journal of Radiology

Tập 94 Số 1123

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