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Utility of Sonazoid-Enhanced Ultrasound for the Macroscopic Classification of Hepatocellular Carcinoma: A Meta-analysis

  • Author Footnotes
    1 Equal contributors.
    Zijie Zheng
    Footnotes
    1 Equal contributors.
    Affiliations
    Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
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  • Author Footnotes
    1 Equal contributors.
    Wei Xie
    Footnotes
    1 Equal contributors.
    Affiliations
    Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
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  • Jing Tian
    Affiliations
    Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
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  • Jiayi Wu
    Affiliations
    Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
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  • Author Footnotes
    2 Contributed equally to this work and should be both recognized as corresponding authors.
    Baoming Luo
    Footnotes
    2 Contributed equally to this work and should be both recognized as corresponding authors.
    Affiliations
    Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
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  • Author Footnotes
    2 Contributed equally to this work and should be both recognized as corresponding authors.
    Xiaolin Xu
    Correspondence
    Address correspondence to: Xiaolin Xu, Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiangxi Road, Guangzhou 510120, China
    Footnotes
    2 Contributed equally to this work and should be both recognized as corresponding authors.
    Affiliations
    Department of Ultrasound, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Author Footnotes
    1 Equal contributors.
    2 Contributed equally to this work and should be both recognized as corresponding authors.

      Abstract

      We assessed the diagnostic value of Sonazoid-enhanced ultrasound (SEUS) in determining the macroscopic classification of hepatocellular carcinoma (HCC) because of its strong relevance to the poor prognosis of the non-simple nodular (non-SN) type. The PubMed, EMBASE, Web of Science and Cochrane Library databases were searched for studies investigating patients who underwent surgery for HCC after undergoing SEUS pre-operatively. Five studies involving a total of 334 patients met the inclusion criteria. The summary sensitivity and specificity were 0.74 (95% confidence interval [CI]: 0.63–0.83) and 0.92 (95% CI: 0.82–0.97), respectively. The positive and negative likelihood ratios of SEUS for determining the macroscopic classification of HCC in Kupffer phase were 9.21 (95% CI: 4.02–21.13) and 0.28 (95% CI: 0.19–0.41), respectively. The diagnostic odds ratio of SEUS for determining the macroscopic classification of HCC was 34.2 (95% CI: 11.64–100.51), and the area under the summary receiver operating characteristic curve was 0.87 (95% CI: 0.84–0.90). Subgroup analysis suggested that small HCCs (≤30 mm) and studies including fewer than 70 patients may be associated with a higher diagnostic odds ratio than the corresponding subsets. SEUS had moderate diagnostic value for determining the macroscopic classification of HCC in the Kupffer phase.

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