Magnetic resonance elastography can predict the development of hepatocellular carcinoma: a meta-analysis and systematic review

Abstract

Background: Hepatocellular carcinoma (HCC) has become the third leading cause of cancer-related death worldwide, and its incidence rate is increasing. Magnetic resonance elastography (MRE) can indirectly realize the accurate non-invasive evaluation of liver reserve function in HCC patients. In this study, we aimed to evaluate the effectiveness of MRE in the diagnosis of HCC patients.Methods: We searched globally-recognized electronic databases, such as PubMed, EMBASE, China National Knowledge Infrastructure, and Cochrane Central, for relevant literature on MRE prediction of HCC. The diagnostic performance of all studies was quantitatively summarized using a bivariate random effects model including heterogeneity analysis, receiver operating characteristic (ROC) curve, and bias determination.Results: The diagnostic accuracy of MRE for HCC was based on 1,735 patients. The sensitivity (31-100%) was lower than the specificity (81-94%). The overall sensitivity was 64% [95% confidence interval (CI): 46-79%; I 2 =92.44%], and the overall specificity was 85% (95% CI: 82-88%; I 2 =67.86%). Limited publication bias was observed in this study, and the sensitivity analysis showed that the study was robust. Discussion:The results of our meta-analysis show that MRE has moderate sensitivity and excellent specificity in the detection of HCC. MRE can be an effective diagnostic tool for HCC and can provide strong support for the selection of clinical treatment methods and prognostic judgment.

Liver Cancer Vascularity Driven by Extracellular Matrix Stiffness

“…Increasing liver tumor stiffness has been associated with worse outcomes after radiofrequency ablation and transarterial hepatic chemoembolization 10–12 . Stiffness quantification of liver tumors with magnetic resonance elastography also proved useful in distinguishing well and moderately differentiated HCC from poorly differentiated HCC 13,14 . These studies established the relevance of HCC tumor stiffness measurements for patient management but did not characterize accompanying perfusion features.…”

Assessment of an MR Elastography‐Based Nomogram as a Potential Imaging Biomarker for Predicting Microvascular Invasion of Hepatocellular Carcinoma

“…MR elastography (MRE) is a rapidly developing dynamic elasticity imaging technique that uses mechanical waves to quantitatively assess the shear modulus or stiffness of tissue, which involves the following three steps including generating shear waves in the tissue, acquiring MR images depicting the propagation of the induced shear waves, and processing the images of the shear waves to generate quantitative maps of tissue stiffness, called elastograms 11,12 . It is an established quantitative method with high diagnostic performance in staging liver fibrosis 13 and has been increasingly widely applied in the characterization, monitoring, and survival of HCC 14–16 . A recent study from Li et al 17 demonstrated that MRE‐based shear strain mapping was a promising technique for predicting MVI in patients with HCC.…”

“…11,12 It is an established quantitative method with high diagnostic performance in staging liver fibrosis 13 and has been increasingly widely applied in the characterization, monitoring, and survival of HCC. [14][15][16] A recent study from Li et al 17 demonstrated that MRE-based shear strain mapping was a promising technique for predicting MVI in patients with HCC. However, only a limited sample size of 59 patients were enrolled without validation set, and they applied the technique of shear strain mapping without analyzing clinical or conventional imaging features.…”