Diagnostic accuracy of contrast-enhanced ultrasound for renal cell carcinoma: a meta-analysis
Tóm tắt
This meta-analysis aimed to identify the accuracy of contrast-enhanced ultrasonography (CEUS) for the diagnosis of renal cell carcinoma (RCC). We searched PubMed, Web of Science, Google Scholar, Cochrane Library, CISCOM, CINAHL, EBSCO, and CBM databases from inception through August 1, 2013 without language restrictions. Meta-analysis was conducted using STATA version 12.0 and Meta-Disc version 1.4 softwares. We calculated the summary statistics for sensitivity (Sen), specificity (Spe), positive and negative likelihood ratio (LR+/LR−), diagnostic odds ratio (DOR), and receiver operating characteristic (SROC) curve. Eleven studies that met all inclusion criteria were included in this meta-analysis. A total of 567 RCC patients and 313 patients with benign renal tumors were assessed. All renal lesions were histologically confirmed after CEUS. The pooled Sen was 0.88 (95 %CI = 0.85 ∼ 0.90); the pooled Spe was 0.80 (95 %CI = 0.75 ∼ 0.85). The pooled LR+ was 4.30 (95 %CI = 2.65 ∼ 6.99); the pooled negative LR− was 0.11 (95 %CI = 0.05 ∼ 0.22). The pooled DOR of CEUS in the diagnosis of RCC was 46.97 (95 % CI = 16.72 ∼ 131.97). The area under the SROC curve was 0.922 (standard error [SE] = 0.039). We found no evidence for publication bias (t = −1.00, P = 0.342). Our meta-analysis indicates that CEUS may have high diagnostic accuracy in differential diagnosis between benign and malignant renal tumors. Thus, CEUS may be a good tool for the diagnosis of RCC.
Tài liệu tham khảo
Vegso G, Toronyi E, Hajdu M, Piros L, Gorog D, Deak PA, et al. Renal cell carcinoma of the native kidney: a frequent tumor after kidney transplantation with favorable prognosis in case of early diagnosis. Transplant Proc. 2011;43(4):1261–3.
Jiang J, Chen Y, Zhou Y, Zhang H. Clear cell renal cell carcinoma: contrast-enhanced ultrasound features relation to tumor size. Eur J Radiol. 2010;73(1):162–7.
Linehan WM, Bratslavsky G, Pinto PA, Schmidt LS, Neckers L, Bottaro DP, et al. Molecular diagnosis and therapy of kidney cancer. Annu Rev Med. 2010;61:329–43.
Escudier B, Kataja V. Renal cell carcinoma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2009;20 Suppl 4:81–2.
Tranquart F, Correas JM, Martegani A, Greppi B, Bokor D. Feasability of real time contrast enhanced ultrasound in renal disease. J Radiol. 2004;85(1):31–6.
Wang Z, Tang J, An L, Wang W, Luo Y, Li J, et al. Contrast-enhanced ultrasonography for assessment of tumor vascularity in hepatocellular carcinoma. J Ultrasound Med. 2007;26(6):757–62.
Jakobsen JA, Oyen R, Thomsen HS, Morcos SK. Safety of ultrasound contrast agents. Eur Radiol. 2005;15(5):941–5.
McArthur C, Baxter GM. Current and potential renal applications of contrast-enhanced ultrasound. Clin Radiol. 2012;67(9):909–22.
Zhou X, Yan F, Luo Y, Peng YL, Parajuly SS, Wen XR, et al. Characterization and diagnostic confidence of contrast-enhanced ultrasound for solid renal tumors. Ultrasound Med Biol. 2011;37(6):845–53.
Xu ZF, Xu HX, Xie XY, Liu GJ, et al. Renal cell carcinoma: Real-time contrast-enhanced ultrasound findings. Abdom Imaging. 2010;35(6):750–6.
Drucker BJ. Renal cell carcinoma: current status and future prospects. Cancer Treat Rev. 2005;31(7):536–45.
Sanchez K, Barr RG. Contrast-enhanced ultrasound detection and treatment guidance in a renal transplant patient with renal cell carcinoma. Ultrasound Quarterly. 2009;25(4):171–3.
Xu ZF, Xu HX, Xie XY, Liu GJ, Zheng YL, Lu MD. Renal cell carcinoma and renal angiomyolipoma: differential diagnosis with real-time contrast-enhanced ultrasonography. J Ultrasound Med. 2010;29(5):709–17.
Whiting PF, Weswood ME, Rutjes AW, Reitsma JB, Bossuyt PN, Kleijnen J. Evaluation of quadas, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol. 2006;6:9.
Hamza TH, Arends LR, van Houwelingen HC, Stijnen T. Multivariate random effects meta-analysis of diagnostic tests with multiple thresholds. BMC Med Res Methodol. 2009;9:73.
Zintzaras E, Ioannidis JP. Hegesma: genome search meta-analysis and heterogeneity testing. Bioinformatics. 2005;21(18):3672–3.
Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Comparison of two methods to detect publication bias in meta-analysis. JAMA. 2006;295(6):676–80.
Wang F, Dai YP, Wan GS, Liang YY, Deng CH, Guo Y. A comparison study of contrast-enhanced ultrasonography and contrast-enhanced computed-tomography in the diagnosis of renal cell carcinoma. J Clin Urol. 2008;23(1):18–21.
Fan L, Lianfang D, Jinfang X, Yijin S, Ying W. Diagnostic efficacy of contrast-enhanced ultrasonography in solid renal parenchymal lesions with maximum diameters of 5 cm. J Ultrasound Med. 2008;27(6):875–85.
Liu J, Yang SX, Chen WW, Wang LL. The clinical value of ultrasonic contrast in the diagnosis of small renal carcinoma. J Clin Urol. 2008;23(7):499–501.
Wang Y, Jiang Y, Zhao YX, Yao GL, Zhang JP, Kang HL, et al. Value of contrast-enhanced ultrasonography in the diagnosis and differential diagnosis of renal tumors. Shanghai Med Imaging. 2009;18(4):285–7.
Ignee A, Straub B, Brix D, Schuessler G, Ott M, Dietrich CF. The value of contrast enhanced ultrasound (CEUS) in the characterisation of patients with renal masses. Clin Hemorheol Microcirc. 2010;46(4):275–90.
Xu ZF, Xie XY, Xu HX, Chen JX, Liu GJ, Lv MD. Comparison study of contrast-enhanced ultrasound and contrast ct on diagnosis of renal cell carcinoma. Chin J Urol. 2010;31(7):452–5.
Chen SH, Yang B, Lu GM. A comparison analysis of contrast-enhanced ultrasonography and contrast-enhanced computed-tomography in the diagnosis of renal lesions. J Med Imaging. 2011;21(9):1382–5.
Wang XH, Wang YJ, Lei CG. Evaluating the perfusion of occupying lesions of kidney and bladder with contrast-enhanced ultrasound. Clin Imaging. 2011;35(6):447–51.
Yuan XC, Wang Y, Zhou AY, Chen L, Den LY, Liu J. Comparison on contrast-enhanced ultrasonography and ct in diagnosing renal cell carcinoma. Chin J Med Imaging Technol. 2011;27(12):2502–5.
Lu Q, Wang W, Huang B, Li C. Minimal fat renal angiomyolipoma: the initial study with contrast-enhanced ultrasonography. Ultrasound Med Biol. 2012;38(11):1896–901.
Cheng WR. Application value of ultrasonogaphy in the diagnosis and differential diagnosis for kidney tumors. Hebei Med. 2013;19(7):977–80.
Hooley RJ, Scoutt LM, Philpotts LE. Breast ultrasonography: state of the art. Radiology. 2013;268(3):642–59.
Bora MK. Internal jugular phlebectasia: diagnosis by ultrasonography, doppler and contrast ct. J Clin Diagn Res. 2013;7(6):1194–6.
Postema M, Gilja OH. Contrast-enhanced and targeted ultrasound. World J Gastroenterol. 2011;17(1):28–41.
Kim AY, Kim SH, Kim YJ, Lee IH. Contrast-enhanced power doppler sonography for the differentiation of cystic renal lesions: preliminary study. J Ultrasound Med. 1999;18(9):581–8.
Spira D, Neumeister H, Spira SM, Hetzel J, Spengler W, von Weyhern CH, et al. Assessment of tumor vascularity in lung cancer using volume perfusion ct (VPCT) with histopathologic comparison: a further step toward an individualized tumor characterization. J Comput Assist Tomogr. 2013;37(1):15–21.
Xue LY, Lu Q, Huang BJ, Li CL, Yan CJ, Wen JX, et al. Evaluation of renal urothelial carcinoma by contrast-enhanced ultrasonography. Eur J Radiol. 2013;82(4):e151–7.
Reichelt O, Wunderlich H, Weirich T, Schlichter A, Schubert J. Computerized contrast angiosonography: a new diagnostic tool for the urologist? BJU Int. 2001;88(1):9–14.
Ogawa S, Lee TM, Kay AR, Tank DW. Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci U S A. 1990;87(24):9868–72.
Pugliese F, Mollet NR, Runza G, van Mieghem C, Meijboom WB, Malagutti P, et al. Diagnostic accuracy of non-invasive 64-slice ct coronary angiography in patients with stable angina pectoris. Eur Radiol. 2006;16(3):575–82.