Is there added value of the hepatobiliary phase of MRI with hepatobiliary contrast agents for hepatocellular carcinoma diagnosis? A meta-analysis.

Purpose: So far, there have been published several meta-analyses which focused on hepatocellular carcinoma (HCC) detection with hepatobiliary phase (HBP) contrast agents. However, only a few of them aimed at establishing whether there is any added value of the HBP itself for HCC diagnosis. To answer the question, we performed a systematic literature search with the time limit going back to 2010. Material and methods: True positive, false positive, false negative, and true negative values with and without the HBP were extracted from the included studies. Pooled sensitivities and specificities with and without the HBP were calculated and summary receiver operating characteristics curves were drawn to assess the diagnostic performance of the studies with and without the HBP. Results: A total of 13 studies were included involving 1184 HCC lesions. In 13 studies without the HBP, the pooled sensitivity, specificity, and area under the curve (AUC) were 0.83, 0.89 and 0.94 respectively. In 13 studies with the HBP, the pooled sensitivity, specificity and AUC were 0.91, 0.85 and 0.98 respectively. Conclusions: We found no statistically significant differences in sensitivities between studies with and without the HBP (