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.
Key Words
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Article info
Publication history
Published online: August 24, 2022
Accepted:
June 20,
2022
Received in revised form:
June 17,
2022
Received:
September 3,
2021
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