ObjectiveTo systematically review the diagnostic value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for liver metastases. MethodsWe searched databases including CNKI, CBM, VIP, WanFang Data, PubMed, EMbase and The Cochrane Library from January 2011 to December 2014 to collect diagnostic tests about Gd-EOB-DTPA for liver metastases. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies by using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) tool. Then, meta-analysis was performed by using Stata 12.0 software. ResultsA total of 15 studies from seven countries were included, involving 2 040 nodules from 701 patients. The results of meta-analysis showed that, the pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic odds ratio (DOR) of Gd-EOB-DTPA for liver metastases were 0.92 (95%CI 0.89 to 0.95), 0.94 (95%CI 0.89 to 0.97), 14.51 (95%CI 8.01 to 26.28), 0.08 (95%CI 0.06 to 0.12), and 177.98 (95%CI 89.50 to 353.94), respectively. The area under curve (AUC) of SROC was 0.97 (95%CI 0.95 to 0.98). The results of subgroup analysis showed that Gd-EOB-DTPA had better Sen in nodules >10 mm than the nodules ≤10 mm in diameter (>10 mm: pooled Sen=0.97, 95%CI 0.94 to 0.99; ≤10 mm: pooled Sen=0.75, 95%CI 0.65 to 0.85; P<0.001); The 3.0T MR had better Sen in diagnosing liver metastases compared with 1.5T MR (3.0T: pooled Sen=0.95, 95%CI 0.92 to 0.97; 1.5T: pooled Sen=0.90, 95%CI 0.87 to 0.94; P<0.001). ConclusionGdEOB-DTPA is of value for the detection of liver metastases. In particular, it is of high sensitivity for the detection of nodules larger than 10 mm, and for the cases using 3.0T high-field MR system. Due to limited quantity and quality of the included studies, more high-quality studies are required to verify the above conclusion.
ObjectiveTo systematically evaluate the value of magnetic resonance imaging (MRI) combined with ultrasound in the diagnosis of node metastases in breast cancer patients. MethodsThe articles concerning the diagnosis of node metastases by using MRI combined with ultrasound until September 2016 were searched in the databases including The Cochrane Library, PubMed, EMbase, Web of Science, CBM, WanFang Data and CNKI. Two reviewers independently screened literature, extracted data according to pre-set included and excluded criteria, and assessed the risk of bias of included studies by using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) tool. Then, meta-analysis was performed by using Stata 12.0 software. The pooled weighted sensitivity (Sen), specificity (Spe), Positive likehoodn (+LR), Negative likehood (-LR) and diagnostic odds ratio (DOR) were calculated, the summary receiver operating characteristic (SROC) curve was drawn and the area under the curve was calculated. ResultsA total of eight studies were included, involving 2 288 patients. The pooled Sen, Spe, +LR,-LR, DOR and area under SROC curve of MRI combined with ultrasound in the diagnosis of breast cancer patients with node metastases were 0.74 (95%CI 0.54 to 0.87), 0.95 (95%CI 0.88 to 0.98), 13.95 (95%CI 6.04 to 32.22), 0.28 (95%CI 0.15 to 0.52), 50.38 (95%CI 17.56 to 144.60), and 0.94 (95%CI 0.91 to 0.96), respectively. ConclusionMRI combined with ultrasound has more diagnostic efficiency for assessing lymph node in breast cancer, therefore, it can be used as an effective method with the diagnosis of node metastases in breast cancer patients.