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European Radiology
Published in: European Radiology 5/2020

Open Access 01-05-2020 | Portal Vein Thrombosis | Hepatobiliary-Pancreas

Contrast-enhanced ultrasound for the characterization of portal vein thrombosis vs tumor-in-vein in HCC patients: a systematic review and meta-analysis

Authors: Jifan Chen, Jianing Zhu, Chao Zhang, Yue Song, Pintong Huang

Published in: European Radiology | Issue 5/2020

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Abstract

Objectives

Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. However, differentiation of thrombosis and tumor-in-vein (TIV) may be challenging. Contrast-enhanced ultrasound (CEUS) is an excellent method for detection of vascularization and could help in the distinction. We performed a systematic review and meta-analysis for evaluating the diagnostic value of CEUS in differentiating between PVT and TIV in hepatocellular carcinoma (HCC) patients.

Methods

PubMed, Embase, Cochrane Library, and Web of Science were searched up to the 5th of May 2019. The study quality was assessed by QUADAS-2 tool. Pooled sensitivity and specificity were calculated by the bivariate random effect model and hierarchical summary receiver-operating characteristic (SROC) curve was plotted.

Results

Seven studies including 425 participants were analyzed after screening 986 articles searched from databases. The pooled sensitivity and specificity of CEUS in diagnosing TIV were 0.94 (95%CI, 0.89–0.97) and 0.99 (95%CI, 0.80–1.00), respectively. The area under the curve (AUC) of SROC curve was 0.97 (95%CI, 0.95–0.98). The pooled sensitivity and AUC were consistent across all the subgroups of different subject numbers, country, study design, CEUS contrast agents, and diagnostic criteria.

Conclusions

CEUS is highly efficient in differentiating TIV from PVT and is an alternative or a substitute for CT and/or MRI.

Trial registration

PROSPERO registration number: CRD42019138847

Key Points

• Characterization of portal vein thrombosis (PVT) vs tumor-in-vein (TIV) is critical for HCC staging.
• CEUS has an excellent safety profile, provides a real-time analysis without any loss in accuracy compared with CT and MRI.
• This meta-analysis demonstrates that contrast-enhanced ultrasound (CEUS) is a suitable method for the detection of PVT and distinction with TIV.
Appendix
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Metadata
Title
Contrast-enhanced ultrasound for the characterization of portal vein thrombosis vs tumor-in-vein in HCC patients: a systematic review and meta-analysis
Authors
Jifan Chen
Jianing Zhu
Chao Zhang
Yue Song
Pintong Huang
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06649-z

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