Abbreviated MRI for hepatocellular carcinoma screening: A systematic review and meta-analysis.

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Biannual ultrasound (US) has poor sensitivity in screening of hepatocellular carcinoma (HCC). Magnetic resonance imaging (MRI) is accurate for detection of HCC, but a complete MRI (cMRI) is not feasible as a screening tool. Abbreviated MRI (AMRI) is an acceptable alternative. The diagnostic performance of different AMRI protocols in not known. We performed a systematic review to determine the diagnostic accuracy of AMRI in HCC screening.We searched the MEDLINE and EMBASE databases for studies reporting the diagnostic accuracy of AMRI in screening of HCC. The pooled sensitivity and specificity of different AMRI protocols were calculated based on random intercept logistic regression model. The diagnostic performance of AMRI was compared with US. Quality of studies was assessed using QUADAS-2 tool.Of the 11327 studies screened by titles, 15 studies (3 prospective and 12 retrospective, 2807 patients, 917 HCC) were included in the final analysis. The pooled per-patient sensitivity and specificity were 86% (95% CI: 84%-88%, I2 0%) and 94% (95% CI: 91-96%, I2 83%), respectively. Pooled per-lesion sensitivity was 77% (95% CI: 74-81%, I2 8%). There was no influence of study type, screening setting, reference standard, and presence and etiology of cirrhosis on the performance of AMRI. The sensitivity of AMRI for detection of HCC<2 cm was lower than that for HCC≥2cm (69% vs. 86%). The sensitivity and specificity of NC-AMRI were comparable to CE-AMRI [86% and 94% vs.87% and 94%]. The diagnostic performance of different NC-AMRI and CE-AMRI protocols was comparable. The sensitivity of US was lower than AMRI (53% vs. 82%).AMRI has high sensitivity and specificity for HCC screening. Different AMRI protocols have comparable diagnostic performance.


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