Diagnostic accuracy of contrast-enhanced ultrasound for renal cell carcinoma: a meta-analysis

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.