Diagnostic Values of Magnetic Resonance Imaging and Computed Tomography for Predicting Macrotrabecular-Massive Hepatocellular Carcinoma Subtype: A Meta-analysis.

Background: The diagnostic accuracy of magnetic resonance imaging (MRI) vs. computed tomography (CT) for predicting macrotrabecular-massive hepatocellular carcinoma (MTM-HCC) is yet to be ascertained. Therefore, this meta-analysis aimed to summarise the diagnostic accuracies of MRI and CT for MTM-HCC.

Methods: A comprehensive literature search of PubMed and Embase was conducted up to 20 August 2024, to evaluate the diagnostic performance of MRI and CT for the diagnosis of MTM-HCC. Pooled sensitivity and specificity were calculated for MRI and CT using a bivariate random-effects model. Subgroup analyses based on different covariates were conducted to compare the diagnostic performances of MRI and CT.

Results: 15 studies involving 2299 patients, including 706 with MTM-HCC and 1593 with non-MTM-HCC were analysed. Comparative analysis revealed no significant differences between MRI and CT in pooled sensitivity (66% vs. 82%, respectively) and specificity (88% vs. 79%, respectively) for the diagnosis of MTM-HCC (P=0.53), with comparable areas under the summary receiver operating characteristic curves of 0.87 and 0.86, respectively. In the subgroup analysis of imaging methods within radiomics, CT had significantly higher sensitivity and specificity than MRI (98% vs. 85% [sensitivity], 83% vs. 79% [specificity], P=0.01). In the other subgroups, including age, the most common aetiology of liver disease, the proportion of patients with cirrhosis, and tumour size, there were no significant differences (all P>0.05).

Conclusion: CT and MRI had comparable predictive performances for the non-invasive diagnosis of MTM-HCC. In the subgroup of radiomics-based imaging methods, CT outperformed MRI. Nevertheless, multicenter prospective studies with uniform design are needed to confirm these findings.