Does contrast-enhanced intraoperative ultrasound improve the sensitivity and predictive value of colorectal cancer liver metastasis detection?

Abstract

We read the recent published paper in this journal of J Gastrointest Oncol by Chen and colleagues entitled "Improved sensitivity and positive predictive value of contrast-enhanced intraoperative ultrasound in colorectal cancer liver metastasis: a systematic review and meta-analysis" (1). They performed a systematic review and meta-analysis to assess the sensitivity and predictive value of contrast-enhanced intraoperative ultrasound (CE-IOUS) in colorectal cancer liver metastasis (CRLM) patients undergoing surgery. We appreciate Chen et al. (1) for the valuable study, however, after a careful learning of the literature, several limitations should be noticed.First, in the overall analyses of CE-IOUS section of the article, the summary receiver operating characteristics curve revealed a higher accuracy with area under the curve (AUC) 0.9753. The authors believed that the closer the AUC is to 1.0, the higher the sensitivity and predictive value of CE-IOUS and the more benefit. However, we believe that the interpretation of the results was false, as the AUC displayed the performance of CE-IOUS in the detection of CRLM not the accuracy, sensitivity, predictive value, and benefit. Furthermore, the same issues exist in the overall analyses of overall analyses of IOUS section of the article.Second, in the statistical analysis section of the article,