Risk factors for hypervascularization in hepatobiliary phase hypointense nodules without arterial phase hyperenhancement: A systematic review and meta-analysis Review

  

Authors:	Kim, T. H.; Woo, S.; Han, S.; Suh, C. H.; Do, R. K. G.; Lee, J. M.
Review Title:	Risk factors for hypervascularization in hepatobiliary phase hypointense nodules without arterial phase hyperenhancement: A systematic review and meta-analysis
Abstract:	Rationale and Objectives: To perform a systematic review and meta-analysis to determine risk factors for hypervascularization in hepatobiliary phase (HBP) hypointense nodules without arterial phase hyperenhancement (APHE) in patients with hepatocellular carcinoma (HCC). Materials and Methods: Pubmed and EMBASE databases were searched up to May 7, 2020. Studies which evaluated radiologic and clinical risk factors for hypervascularization in HBP hypointense nodules without APHE were included. Hazard ratios were meta-analytically pooled using random-effects model. Methodological quality of included studies was assessed using Quality in Prognostic Studies (QUIPS) tool. Results: Sixteen studies with 934 patients were included. HBP hypointense nodules without APHE with baseline size greater than 10 mm, T2 hyperintensity, and restricted diffusion showed risk for hypervascularization with pooled HRs of 2.95 (95% confidence interval [CI], 1.94–4.20), 4.21 (95% CI, 1.15–15.40), 5.83 (95% CI, 1.42–23.95), respectively. Previous HCC history contributed to hypervascularization of the nodules with hazard ratio of 2.06 (95% CI, 1.23–3.44). T1 hyperintensity, intralesional fat, Child-Pugh Class B, sex, alfa-fetoprotein, hepatitis B or C infection were not significant risk factors for hypervascularization (p ≥0.05). Study quality was generally moderate. Conclusion: HBP hypointense nodules without APHE on gadoxetic acid-enhanced MRI with baseline size greater than 10 mm, T2 hyperintensity, restricted diffusion and previous hepatocellular carcinoma history pose higher risk for hypervascularization. Proper patient management in patients with HBP hypointense nodules without APHE on gadoxetic acid-enhanced MRI may need to be tailored according to these risk factors. © 2020 The Association of University Radiologists
Keywords:	clinical feature; hepatocellular carcinoma; hepatitis b; hepatitis c; liver cell carcinoma; nuclear magnetic resonance imaging; protein blood level; vascularization; risk factor; patient care; systematic review; quantitative analysis; contrast enhancement; medline; hepatobiliary disease; meta analysis; alpha fetoprotein; meta-analysis; embase; cardiovascular parameters; superparamagnetic iron oxide; liver carcinogenesis; cancer prognosis; gadoxetic acid; child pugh score; gd-eob-dtpa; human; male; female; article; preferred reporting items for systematic reviews and meta-analyses; arterial phase hyperenhancement; hypervascularization
Journal Title:	Academic Radiology
Volume:	29
Issue:	2
ISSN:	1076-6332
Publisher:	Elsevier Science, Inc.
Date Published:	2022-02-01
Start Page:	198
End Page:	210
Language:	English
DOI:	10.1016/j.acra.2020.08.031
PUBMED:	32962925
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85091213692&doi=10.1016%2fj.acra.2020.08.031&partnerID=40&md5=59d367099236867301152adc167d04f8
Notes:	Article -- Export Date: 1 February 2022 -- Source: Scopus

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