Hepatic Adenoma Subtypes on Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI: Systematic Review and Meta-Analysis
Accumulating evidence indicates that hepatocellular adenoma (HCA) may have a higher frequency of hepatobiliary phase (HBP) iso- or hyperintensity than previously reported. The purpose of this study was to evaluate the proportion of HCA that shows iso- or hyperintensity in the HBP of gadoxetic acid-e...
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| Veröffentlicht in: | American journal of roentgenology (1976) 2023-01, Vol.220 (1), p.28-38 |
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| creator | Kim, Tae-Hyung Woo, Sungmin Ebrahimzadeh, Sanam McInnes, Matthew D F Gerst, Scott R Do, Richard K |
| description | Accumulating evidence indicates that hepatocellular adenoma (HCA) may have a higher frequency of hepatobiliary phase (HBP) iso- or hyperintensity than previously reported.
The purpose of this study was to evaluate the proportion of HCA that shows iso- or hyperintensity in the HBP of gadoxetic acid-enhanced MRI, stratified by HCA subtype (
-inactivated [H-HCA], inflammatory [I-HCA], β-catenin-activated [B-HCA], and unclassified [U-HCA] HCA), and to assess the diagnostic performance of HBP iso- or hyperintensity for differentiating focal nodular hyperplasia (FNH) from HCA.
PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched through February 14, 2022, for articles reporting HBP signal intensity on gadoxetic acid-enhanced MRI among pathologically proven HCAs, stratified by subtype. The pooled proportion of HBP iso- or hyperintensity was determined for each subtype and compared using metaregression. Diagnostic performance of HBP iso- or hyperintensity for differentiating FNH from all HCA subtypes combined and from B-HCA and U-HCA combined was assessed using bivariate modeling.
Twenty-eight studies (12 original investigations, 16 case reports or case series) were included, yielding 364 patients with 410 HCAs (112 H-HCAs, 203 I-HCAs, 33 B-HCAs, 62 U-HCAs). Pooled proportion of HBP iso- or hyperintensity was 14% (95% CI, 4-26%) among all HCAs, 0% (95% CI, 0-2%) among H-HCAs, 11% (95% CI, 0-29%) among U-HCAs, 14% (95% CI, 2-31%) among I-HCAs, and 59% (95% CI, 26-88%) among B-HCAs; metaregression showed significant difference among subtypes (
< .001). In four studies reporting diagnostic performance information, HBP iso- or hyperintensity had sensitivity of 99% (95% CI, 57-100%) and specificity of 89% (95% CI, 82-94%) for differentiating FNH from all HCA subtypes and sensitivity of 99% (95% CI, 53-100%) and specificity of 65% (95% CI, 44-80%) for differentiating FNH from B-HCA or U-HCA.
HCA subtypes other than H-HCA show proportions of HBP iso- or hyperintensity ranging from 11% (U-HCA) to 59% (B-HCA). Low prevalence of B-HCA has contributed to prior reports of high diagnostic performance of HBP iso- or hyperintensity for differentiating FNH from HCA.
Radiologists should recognize the low specificity of HBP iso- or hyperintensity on gadoxetic acid-enhanced MRI for differentiating FNH from certain HCA subtypes. |
| doi_str_mv | 10.2214/AJR.22.27989 |
| format | Article |
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The purpose of this study was to evaluate the proportion of HCA that shows iso- or hyperintensity in the HBP of gadoxetic acid-enhanced MRI, stratified by HCA subtype (
-inactivated [H-HCA], inflammatory [I-HCA], β-catenin-activated [B-HCA], and unclassified [U-HCA] HCA), and to assess the diagnostic performance of HBP iso- or hyperintensity for differentiating focal nodular hyperplasia (FNH) from HCA.
PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched through February 14, 2022, for articles reporting HBP signal intensity on gadoxetic acid-enhanced MRI among pathologically proven HCAs, stratified by subtype. The pooled proportion of HBP iso- or hyperintensity was determined for each subtype and compared using metaregression. Diagnostic performance of HBP iso- or hyperintensity for differentiating FNH from all HCA subtypes combined and from B-HCA and U-HCA combined was assessed using bivariate modeling.
Twenty-eight studies (12 original investigations, 16 case reports or case series) were included, yielding 364 patients with 410 HCAs (112 H-HCAs, 203 I-HCAs, 33 B-HCAs, 62 U-HCAs). Pooled proportion of HBP iso- or hyperintensity was 14% (95% CI, 4-26%) among all HCAs, 0% (95% CI, 0-2%) among H-HCAs, 11% (95% CI, 0-29%) among U-HCAs, 14% (95% CI, 2-31%) among I-HCAs, and 59% (95% CI, 26-88%) among B-HCAs; metaregression showed significant difference among subtypes (
< .001). In four studies reporting diagnostic performance information, HBP iso- or hyperintensity had sensitivity of 99% (95% CI, 57-100%) and specificity of 89% (95% CI, 82-94%) for differentiating FNH from all HCA subtypes and sensitivity of 99% (95% CI, 53-100%) and specificity of 65% (95% CI, 44-80%) for differentiating FNH from B-HCA or U-HCA.
HCA subtypes other than H-HCA show proportions of HBP iso- or hyperintensity ranging from 11% (U-HCA) to 59% (B-HCA). Low prevalence of B-HCA has contributed to prior reports of high diagnostic performance of HBP iso- or hyperintensity for differentiating FNH from HCA.
Radiologists should recognize the low specificity of HBP iso- or hyperintensity on gadoxetic acid-enhanced MRI for differentiating FNH from certain HCA subtypes.</description><identifier>ISSN: 0361-803X</identifier><identifier>ISSN: 1546-3141</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/AJR.22.27989</identifier><identifier>PMID: 35920706</identifier><language>eng</language><publisher>United States</publisher><subject>Adenoma, Liver Cell - diagnostic imaging ; Amines ; Contrast Media ; Diagnosis, Differential ; Focal Nodular Hyperplasia ; Gadolinium DTPA ; Humans ; Liver Neoplasms - diagnostic imaging ; Magnetic Resonance Imaging ; Retrospective Studies ; Sensitivity and Specificity</subject><ispartof>American journal of roentgenology (1976), 2023-01, Vol.220 (1), p.28-38</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-4e8846af5df8e6b9a7a6b7f3cc4ab47761f2c886ad90191322a4855341075b243</citedby><cites>FETCH-LOGICAL-c451t-4e8846af5df8e6b9a7a6b7f3cc4ab47761f2c886ad90191322a4855341075b243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,4106,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35920706$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Tae-Hyung</creatorcontrib><creatorcontrib>Woo, Sungmin</creatorcontrib><creatorcontrib>Ebrahimzadeh, Sanam</creatorcontrib><creatorcontrib>McInnes, Matthew D F</creatorcontrib><creatorcontrib>Gerst, Scott R</creatorcontrib><creatorcontrib>Do, Richard K</creatorcontrib><title>Hepatic Adenoma Subtypes on Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI: Systematic Review and Meta-Analysis</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>Accumulating evidence indicates that hepatocellular adenoma (HCA) may have a higher frequency of hepatobiliary phase (HBP) iso- or hyperintensity than previously reported.
The purpose of this study was to evaluate the proportion of HCA that shows iso- or hyperintensity in the HBP of gadoxetic acid-enhanced MRI, stratified by HCA subtype (
-inactivated [H-HCA], inflammatory [I-HCA], β-catenin-activated [B-HCA], and unclassified [U-HCA] HCA), and to assess the diagnostic performance of HBP iso- or hyperintensity for differentiating focal nodular hyperplasia (FNH) from HCA.
PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched through February 14, 2022, for articles reporting HBP signal intensity on gadoxetic acid-enhanced MRI among pathologically proven HCAs, stratified by subtype. The pooled proportion of HBP iso- or hyperintensity was determined for each subtype and compared using metaregression. Diagnostic performance of HBP iso- or hyperintensity for differentiating FNH from all HCA subtypes combined and from B-HCA and U-HCA combined was assessed using bivariate modeling.
Twenty-eight studies (12 original investigations, 16 case reports or case series) were included, yielding 364 patients with 410 HCAs (112 H-HCAs, 203 I-HCAs, 33 B-HCAs, 62 U-HCAs). Pooled proportion of HBP iso- or hyperintensity was 14% (95% CI, 4-26%) among all HCAs, 0% (95% CI, 0-2%) among H-HCAs, 11% (95% CI, 0-29%) among U-HCAs, 14% (95% CI, 2-31%) among I-HCAs, and 59% (95% CI, 26-88%) among B-HCAs; metaregression showed significant difference among subtypes (
< .001). In four studies reporting diagnostic performance information, HBP iso- or hyperintensity had sensitivity of 99% (95% CI, 57-100%) and specificity of 89% (95% CI, 82-94%) for differentiating FNH from all HCA subtypes and sensitivity of 99% (95% CI, 53-100%) and specificity of 65% (95% CI, 44-80%) for differentiating FNH from B-HCA or U-HCA.
HCA subtypes other than H-HCA show proportions of HBP iso- or hyperintensity ranging from 11% (U-HCA) to 59% (B-HCA). Low prevalence of B-HCA has contributed to prior reports of high diagnostic performance of HBP iso- or hyperintensity for differentiating FNH from HCA.
Radiologists should recognize the low specificity of HBP iso- or hyperintensity on gadoxetic acid-enhanced MRI for differentiating FNH from certain HCA subtypes.</description><subject>Adenoma, Liver Cell - diagnostic imaging</subject><subject>Amines</subject><subject>Contrast Media</subject><subject>Diagnosis, Differential</subject><subject>Focal Nodular Hyperplasia</subject><subject>Gadolinium DTPA</subject><subject>Humans</subject><subject>Liver Neoplasms - diagnostic imaging</subject><subject>Magnetic Resonance Imaging</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><issn>0361-803X</issn><issn>1546-3141</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkUlv1EAQhVsIRIbAjTPqIwec9L5wQaMoZFEi0AQkbq1yu8w0st2D2xOYf4-ZhIicqqT36lWVPkJec3YkBFfHy8vV3BwJ651_QhZcK1NJrvhTsmDS8Mox-e2AvCjlB2PMOm-fkwOpvWCWmQUp57iBKUW6bHDIPdCbbT3tNlhoHuhey3XqEow7-nkNBWlu6Rk0-Tfuh2JqqtNhDUPEhl6vLt7Tm12ZsN9HrvA24S8KwyzhBNVygG5XUnlJnrXQFXx1Xw_J14-nX07Oq6tPZxcny6sqKs2nSqFzykCrm9ahqT1YMLVtZYwKamWt4a2IzhloPOOeSyFAOa2l4szqWih5SD7c5W62dY9NxGEaoQubMfXzPyFDCo-VIa3D93wbOLfaK-vnhLf3CWP-ucUyhT6ViF0HA-ZtCcJ4a6zyms_Wd3fWOOZSRmwf9nAW_oIKM6i5CXtQs_3N_7c9mP-RkX8ALJKPGw</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Kim, Tae-Hyung</creator><creator>Woo, Sungmin</creator><creator>Ebrahimzadeh, Sanam</creator><creator>McInnes, Matthew D F</creator><creator>Gerst, Scott R</creator><creator>Do, Richard K</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230101</creationdate><title>Hepatic Adenoma Subtypes on Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI: Systematic Review and Meta-Analysis</title><author>Kim, Tae-Hyung ; Woo, Sungmin ; Ebrahimzadeh, Sanam ; McInnes, Matthew D F ; Gerst, Scott R ; Do, Richard K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-4e8846af5df8e6b9a7a6b7f3cc4ab47761f2c886ad90191322a4855341075b243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adenoma, Liver Cell - diagnostic imaging</topic><topic>Amines</topic><topic>Contrast Media</topic><topic>Diagnosis, Differential</topic><topic>Focal Nodular Hyperplasia</topic><topic>Gadolinium DTPA</topic><topic>Humans</topic><topic>Liver Neoplasms - diagnostic imaging</topic><topic>Magnetic Resonance Imaging</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Tae-Hyung</creatorcontrib><creatorcontrib>Woo, Sungmin</creatorcontrib><creatorcontrib>Ebrahimzadeh, Sanam</creatorcontrib><creatorcontrib>McInnes, Matthew D F</creatorcontrib><creatorcontrib>Gerst, Scott R</creatorcontrib><creatorcontrib>Do, Richard K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Tae-Hyung</au><au>Woo, Sungmin</au><au>Ebrahimzadeh, Sanam</au><au>McInnes, Matthew D F</au><au>Gerst, Scott R</au><au>Do, Richard K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hepatic Adenoma Subtypes on Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI: Systematic Review and Meta-Analysis</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>220</volume><issue>1</issue><spage>28</spage><epage>38</epage><pages>28-38</pages><issn>0361-803X</issn><issn>1546-3141</issn><eissn>1546-3141</eissn><abstract>Accumulating evidence indicates that hepatocellular adenoma (HCA) may have a higher frequency of hepatobiliary phase (HBP) iso- or hyperintensity than previously reported.
The purpose of this study was to evaluate the proportion of HCA that shows iso- or hyperintensity in the HBP of gadoxetic acid-enhanced MRI, stratified by HCA subtype (
-inactivated [H-HCA], inflammatory [I-HCA], β-catenin-activated [B-HCA], and unclassified [U-HCA] HCA), and to assess the diagnostic performance of HBP iso- or hyperintensity for differentiating focal nodular hyperplasia (FNH) from HCA.
PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched through February 14, 2022, for articles reporting HBP signal intensity on gadoxetic acid-enhanced MRI among pathologically proven HCAs, stratified by subtype. The pooled proportion of HBP iso- or hyperintensity was determined for each subtype and compared using metaregression. Diagnostic performance of HBP iso- or hyperintensity for differentiating FNH from all HCA subtypes combined and from B-HCA and U-HCA combined was assessed using bivariate modeling.
Twenty-eight studies (12 original investigations, 16 case reports or case series) were included, yielding 364 patients with 410 HCAs (112 H-HCAs, 203 I-HCAs, 33 B-HCAs, 62 U-HCAs). Pooled proportion of HBP iso- or hyperintensity was 14% (95% CI, 4-26%) among all HCAs, 0% (95% CI, 0-2%) among H-HCAs, 11% (95% CI, 0-29%) among U-HCAs, 14% (95% CI, 2-31%) among I-HCAs, and 59% (95% CI, 26-88%) among B-HCAs; metaregression showed significant difference among subtypes (
< .001). In four studies reporting diagnostic performance information, HBP iso- or hyperintensity had sensitivity of 99% (95% CI, 57-100%) and specificity of 89% (95% CI, 82-94%) for differentiating FNH from all HCA subtypes and sensitivity of 99% (95% CI, 53-100%) and specificity of 65% (95% CI, 44-80%) for differentiating FNH from B-HCA or U-HCA.
HCA subtypes other than H-HCA show proportions of HBP iso- or hyperintensity ranging from 11% (U-HCA) to 59% (B-HCA). Low prevalence of B-HCA has contributed to prior reports of high diagnostic performance of HBP iso- or hyperintensity for differentiating FNH from HCA.
Radiologists should recognize the low specificity of HBP iso- or hyperintensity on gadoxetic acid-enhanced MRI for differentiating FNH from certain HCA subtypes.</abstract><cop>United States</cop><pmid>35920706</pmid><doi>10.2214/AJR.22.27989</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| source | American Roentgen Ray Society; MEDLINE; Alma/SFX Local Collection |
| subjects | Adenoma, Liver Cell - diagnostic imaging Amines Contrast Media Diagnosis, Differential Focal Nodular Hyperplasia Gadolinium DTPA Humans Liver Neoplasms - diagnostic imaging Magnetic Resonance Imaging Retrospective Studies Sensitivity and Specificity |
| title | Hepatic Adenoma Subtypes on Hepatobiliary Phase of Gadoxetic Acid-Enhanced MRI: Systematic Review and Meta-Analysis |
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