Evidence map›Paper›PMID 33662596›Full record

SynthesisClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2022

Noncontrast MRI for Hepatocellular Carcinoma Detection: A Systematic Review and Meta-analysis - A Potential Surveillance Tool?

Michael Vinchill Chan, Ya Ruth Huo, Nelson Trieu, Amer Mitchelle, Jacob George, Emily He, Alice Unah Lee, Jeff Chang, Jessica Yang

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Comparison of abbreviated MRI and ultrasonography in the detection of early hepatocellular carcinoma: a meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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  20. Abbreviated magnetic resonance imaging in hepatocellular carcinoma surveillance: A review.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Michael Vinchill ChanDepartment of Radiology, Concord Repatriation General Hospital, Sydney, Australia; Concord Hospital Clinical School, The University of Sydney, Sydney, Australia.
Ya Ruth HuoDepartment of Radiology, Concord Repatriation General Hospital, Sydney, Australia; Concord Hospital Clinical School, The University of Sydney, Sydney, Australia.
Nelson TrieuDepartment of Radiology, Concord Repatriation General Hospital, Sydney, Australia; Concord Hospital Clinical School, The University of Sydney, Sydney, Australia.
Amer MitchelleDepartment of Radiology, Concord Repatriation General Hospital, Sydney, Australia.
Jacob GeorgeStorr Liver Centre, Westmead Institute for Medical Research and Department of Gastroenterology and Hepatology, Westmead Hospital, University of Sydney, Sydney, Australia.
Emily HeDepartment of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia.
Alice Unah LeeDepartment of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia.
Jeff ChangDepartment of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia.
Jessica YangDepartment of Radiology, Concord Repatriation General Hospital, Sydney, Australia; Concord Hospital Clinical School, The University of Sydney, Sydney, Australia. Electronic address: jessica.yang1@health.nsw.gov.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThis meta-analysis investigates the diagnostic performance of non-contrast magnetic resonance imaging (MRI) for the detection of hepatocellular carcinoma (HCC).

methodsA systematic review was performed to May 2020 for studies which examined the diagnostic performance of non-contrast MRI (multi-sequence or diffusion-weighted imaging (DWI)- alone) for HCC detection in high risk patients. The primary outcome was accuracy for the detection of HCC. Random effects models were used to pool outcomes for sensitivity, specificity, positive likelihood ratio (LR) and negative LR. Subgroup analyses for cirrhosis and size of the lesion were performed.

resultsTwenty-two studies were included involving 1685 patients for per-patient analysis and 2128 lesions for per-lesion analysis. Multi-sequence non-contrast MRI (NC-MRI) using T2+DWI±T1 sequences had a pooled per-patient sensitivity of 86.8% (95%CI:83.9-89.4%), specificity of 90.3% (95%CI:87.3-92.7%), and negative LR of 0.17 (95%CI:0.14-0.20). DWI-only MRI (DW-MRI) had a pooled sensitivity of 79.2% (95%CI:71.8-85.4%), specificity of 96.5% (95%CI:94.3-98.1%) and negative LR of 0.24 (95%CI:1.62-0.34). In patients with cirrhosis, NC-MRI had a pooled per-patient sensitivity of 87.3% (95%CI:82.7-91.0%) and specificity of 81.6% (95%CI:75.3-86.8%), whilst DWI-MRI had a pooled sensitivity of 71.4% (95%CI:60.5-80.8%) and specificity of 97.1% (95%CI:91.9-99.4%). For lesions <2 cm, the pooled per-lesion sensitivity was 77.1% (95%CI:73.8-80.2%). For lesions >2 cm, pooled per-lesion sensitivity was 88.5% (95%CI:85.0-91.5%).

conclusionNon-contrast MRI has a moderate negative LR and high specificity with acceptable sensitivity for the detection of HCC, even in patients with cirrhosis and with lesions <2 cm. Prospective trials to validate if non-contrast MRI can be used for HCC surveillance is warranted.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsContrast MediaDiffusion Magnetic Resonance ImagingHumansMagnetic Resonance ImagingProspective StudiesSensitivity and SpecificityContrast MediaDiffusion-Weighted ImagingHepatocellular CarcinomaMagnetic Resonance ImagingMeta-AnalysisNoncontrast

Identifiers

PMID33662596

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.