To identify and evaluate the efficiency of the most commonly used parameters applied to gadoxetate disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for liver fibrosis (LF) staging. MATERIALS AND METHODS: Literature searches of PubMed, Web of Science, Embase, and MEDLINE databases from January 2004 to August 2018 were conducted. The applied parameters during imaging were noted and summarised. Studies using the most commonly used parameter were included. Extractive data were combined as pooled weighted mean difference (WMD) to determine the benefits in LF staging. The pooled sensitivity, specificity, and summary receiver operating characteristics (SROC) curve were calculated. RESULTS: Among 57 relevant studies, the contrast enhancement index (CEI) was a relatively commonly used parameter. It was calculated as SI post /SI pre , where SI post and SI pre are the liverto-muscle signal intensity ratios in the hepatocyte phase and pre-enhanced images, respectively. Six studies were included. F0 was regarded as normal liver, F1 as mild LF, F2 as moderate LF, and F3 and F4 as advanced LF. Comparisons of WMD revealed significant differences between F1e2 and F3e4. For stage F1, the pooled sensitivity, specificity, and areas under SROC curve were 0.58, 0.84, and 0.85, respectively; the corresponding values for F2 were 0.57, 0.68, and 0.76, while those for F3 were 0.61, 0.75, and 0.72. CONCLUSION: The methodology and parameters used for Gd-EOB-DTPA-enhanced MRI for LF staging are diverse, but the CEI was a relatively common parameter. Overall, there is evidence to support use of CEI, but more evidence from larger studies is needed.
