Value of Abbreviated Magnetic Resonance Sequence in Hepatocellular Carcinoma Screening: A Systematic Review and...

To systematically review the diagnostic efficacy of abbreviated magnetic resonance imaging sequence (AMRI) screening for hepatocellular carcinoma (HCC).

Medline (via PubMed), EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect studies on the diagnostic efficacy of AMRI screening for HCC from inception to August 10th, 2024. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2), then, the meta-analysis with a bivariate mixed-effects regression model was performed by using Stata 14.0 software.

A total of 19 studies involving 3914 participants were included which published from 2013 to 2024. The results of meta-analysis showed that pooled sensitivity and specificity of AMRI for HCC were 0.85 (95% confidence interval (CI) 0.83 to 0.87) and 0.93 (95%CI 0.91 to 0.94). Subgroup analysis showed that the pooled sensitivity and specificity of NC (Non-Contrast) AMRI and HBP (Hepatobiliary Phase Images) AMRI were 0.84 (95%CI 0.80 to 0.87), 0.92 (95%CI 0.89 to 0.94) and 0.88 (95%CI 0.84 to 0.91), 0.93 (95%CI 0.91 to 0.95), respectively. And the T2 (T2 Weighted Imaging)+DWI (Diffusion Weighted Imaging)+HBP protocol in HBP AMRI had the highest diagnostic efficacy, its pooled sensitivity, specificity and the area under the summary receiver operating characteristic (SROC) curve (AUC) were 0.88 (95%CI 0.83 to 0.92), 0.93 (95%CI 0.91 to 0.95), and 0.96 (95%CI 0.94 to 0.98), respectively.

Current evidence suggests that the AMRI protocols demonstrated potential for HCC detection, which employing a limited number of sequences with the aim of achieving a diagnostic performance comparable to conventional complete contrast-enhanced MRI (CE-MRI). Among them, T2+DWI+HBP protocol shows the relatively highest diagnostic efficiency, which is perhaps the most promising application in clinical practice. Nevertheless, the results still should be carefully interpreted in the relevant context of medical history, physical examination, and biochemical indicators.