Meta-analysis of diagnosis of liver metastatic cancers: Comparison of 18FDG PET-CT and gadolinium-enhanced MRI

Introduction: We performed a meta-analysis to compare the performance of 18F-fluorodeoxyglucose ((18)FDG) positron emission tomography-CT (PET-CT) with that of gadolinium-enhanced MRI for the detection of liver metastatic cancers. Methods: The MEDLINE and EMBASE databases were searched for relevant original articles. The histology and/or imaging follow-up data served as the reference standard. We calculated the pooled sensitivities, specificities, positive likelihood ratios, negative likelihood ratios and constructed summary receiver operating characteristic curves for (18)FDG PET-CT and gadolinium-enhanced MRI, respectively. Results: Ten studies (1105 patients) were included for this meta-analysis. (18)FDG PET-CT has similar patient-based specificity (1.00 and 0.99), positive likelihood ratios (253.1 and 138.2), negative likelihood ratios (0.16 and 0.10) and area under curves (0.99 and 0.99) with gadolinium-enhanced MRI. Gadolinium-enhanced MRI tends to have higher sensitivity (0.91 and 0.84) than (18)FDG PET-CT. Conclusion: Both (18)FDG PET-CT and gadolinium-enhanced MRI have excellent diagnostic performance for the detection of liver metastatic cancer.