Meta-analysis of contrast-enhanced ultrasonography for the detection of gallbladder carcinoma

Abstract

Aim: To systematically evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) for the detection of gallbladder carcinoma. Material and method: Relevant studies were identified searching PubMed, Embase, Elsevier, the CNKI (China National Knowledge Infrastructure) database and the Cochrane Trial Register searches until August 2015. Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic (ROC) curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in the diagnosis of gallbladder carcinoma. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: From 89 citations, 16 were included in the meta-analysis with a total of 1673 lesions. We detected heterogeneity between studies and evidence of publication bias. The methodological quality was moderate. The pooled weighted sensitivity with a corresponding 95% confidence interval (CI) was 0.92 (95%CI: 0.90, 0.94), the specificity was 0.91 (95%CI: 0.89, 0.93), the positive likelihood ratio was 10.01 (95%CI: 7.02, 14.29), the negative likelihood ratio was 0.10 (95%CI: 0.07, 0.14), and the diagnostic odds ratio was 123.02 (95%CI: 78.40, 193.03). The area under the ROC curve was 0.9689 (95%CI: 0.9376, 0.9879). Conclusions: CEUS is a reliable, non-invasive, and no-radiation-exposure imaging modality with a high sensitivity and specificity for detection of gallbladder carcinoma. Nonetheless, it should be applied cautiously, and large scale, well-designed trials are necessary to assess its clinical value.

RETRACTED ARTICLE: Meta-analysis of contrast-enhanced ultrasound and contrast-enhanced harmonic endoscopic ultrasound for the diagnosis of gallbladder malignancy

“…To develop clinical practice, there are some earlier studies systematically assessing the accuracy of CEUS or other methods in detection of GB carcinomas by meta-analysis. (Table 3) Wang et al included 16 studies and drew a similar conclusion that CEUS is a reliable imaging modality with a high sensitivity (0.91) and specificity (0.92) [43]. We found the pooled sensitivity of Wang et al was higher than ours (0.92 vs. 0.81), and a possible explanation might be that the included studies in the two meta-analysis were different because Wang et al also analyzed those studies in Chinese which we excluded because of larger publication bias.…”

Synergistic effects of extracellular vesicle phenotyping and AFP in hepatobiliary cancer differentiation

“…Except for ultrasonography (US) in patients suffering from gallstones as a possible indication for a given GbCA risk, early detection presents difficult. [29][30][31][32] Furthermore, GbCA diagnosis often only occurs incidentally during pathological assessment of routine cholecystectomy specimens due to benign diseases such as gallstones. 33 Hence, biliary cancers are highly fatal diseases, characterized by high mortality and poor 5-year survival rates.…”

Contrast-enhanced ultrasound findings of gallbladder adenocarcinoma with sarcomatoid carcinoma accompanied by intrahepatic metastasis

“…Several studies showed that the utilization of CEUS substantially improves sensitivity and specificity for gallbladder lesions. [2] Compared with the vascular phases of the liver, only 2 vascular phases of the gallbladder can be followed: arterial phase (10–30 seconds after bolus injection) and late phase (31–180 seconds after contrast injection) because the blood supply of the gallbladder is provided entirely by the cystic artery and not by portal vein branches. The late phase persists for a short time in comparison with that in the liver.…”

“…Clinical manifestation and laboratory test are nonspecific for the diagnosis. [1,2] Therefore, imaging finding of this rare tumor is important for its diagnoses. In this paper, we present a case of gallbladder adenocarcinoma with sarcomatoid carcinoma accompanied by intra-hepatic metastasis, with an emphasis on the ultrasound imaging and contrast-enhanced ultrasound (CEUS) finding.…”