Diffusion-weighted imaging(DWI) of the liver can be performed using most commercially available machines and is currently accepted in routine sequence. This sequence has some potential as an imaging biomarker for fibr...Diffusion-weighted imaging(DWI) of the liver can be performed using most commercially available machines and is currently accepted in routine sequence. This sequence has some potential as an imaging biomarker for fibrosis, tumor detection/characterization, and following/predicting therapy. To improve reliability including accuracy and reproducibility, researchers have validated this new technique in terms of image acquisition, data sampling, and analysis. The added value of DWI in contrastenhanced magnetic resonance imaging was established in the detection of malignant liver lesions. However, some limitations remain in terms of lesion characterization and fibrosis detection. Furthermore, the methodologies of image acquisition and data analysis have been inconsistent. Therefore, researchers should make every effort to not only improve accuracy and reproducibility but also standardize imaging parameters.展开更多
AIM To perform a systematic review and meta-analysis for the diagnostic accuracy of in vivo lesion characterization in colonic inflammatory bowel disease(IBD), using optical imaging techniques, including virtual chrom...AIM To perform a systematic review and meta-analysis for the diagnostic accuracy of in vivo lesion characterization in colonic inflammatory bowel disease(IBD), using optical imaging techniques, including virtual chromoendoscopy(VCE), dye-based chromoendoscopy(DBC), magnification endoscopy and confocal laser endomicroscopy(CLE). METHODS We searched Medline, Embase and the Cochrane library. We performed a bivariate meta-analysis to calculate the pooled estimate sensitivities, specificities, positive and negative likelihood ratios(+LHR,-LHR), diagnostic odds ratios(DOR), and area under the SROC curve(AUSROC) for each technology group. A subgroup analysis was performed to investigate differences in real-time nonmagnified Kudo pit patterns(with VCE and DBC) and real-time CLE.RESULTS We included 22 studies [1491 patients; 4674 polyps, of which 539(11.5%) were neoplastic]. Real-time CLE had a pooled sensitivity of 91%(95%CI: 66%-98%), specificity of 97%(95%CI: 94%-98%), and an AUSROC of 0.98(95%CI: 0.97-0.99). Magnification endoscopy had a pooled sensitivity of 90%(95%CI: 77%-96%)and specificity of 87%(95%CI: 81%-91%). VCE had a pooled sensitivity of 86%(95%CI: 62%-95%) and specificity of 87%(95%CI: 72%-95%). DBC had a pooled sensitivity of 67%(95%CI: 44%-84%) and specificity of 86%(95%CI: 72%-94%). CONCLUSION Real-time CLE is a highly accurate technology for differentiating neoplastic from non-neoplastic lesions in patients with colonic IBD. However, most CLE studies were performed by single expert users within tertiary centres, potentially confounding these results.展开更多
We evaluated and compared the diagnostic accuracy(DA) of apparent diffusion coefficient(ADC) values with that of lesion-to-liver ADC ratios in the characterization of solid focal liver lesions(FLLs).This prospective s...We evaluated and compared the diagnostic accuracy(DA) of apparent diffusion coefficient(ADC) values with that of lesion-to-liver ADC ratios in the characterization of solid focal liver lesions(FLLs).This prospective study was approved by the Institutional Human Ethics Board,after waiving written informed consent.Diffusion-weighted imaging and other routine magnetic resonance imaging were performed on 142 consecutive patients with suspected liver disease.The mean ADC values and lesion-to-liver ADC ratios were compared between benign and malignant solid FLLs.Receiver operating characteristic analysis was performed.The study participants included 46 patients(28 men,18 women;mean age,52.5 years) with 57 solid FLLs(32 malignant and 25 benign FLLs).The mean ADC values and ADC ratios of benign solid FLLs were significantly higher than those of malignant lesions(P<0.01).The difference between the area under the receiver operating characteristic curve of the ADC values(0.699) and ADC ratios(0.752) was not significant.Our study suggests that the DA of the ADC ratio is not significantly higher than that of ADC in characterizing solid FLLs.展开更多
文摘Diffusion-weighted imaging(DWI) of the liver can be performed using most commercially available machines and is currently accepted in routine sequence. This sequence has some potential as an imaging biomarker for fibrosis, tumor detection/characterization, and following/predicting therapy. To improve reliability including accuracy and reproducibility, researchers have validated this new technique in terms of image acquisition, data sampling, and analysis. The added value of DWI in contrastenhanced magnetic resonance imaging was established in the detection of malignant liver lesions. However, some limitations remain in terms of lesion characterization and fibrosis detection. Furthermore, the methodologies of image acquisition and data analysis have been inconsistent. Therefore, researchers should make every effort to not only improve accuracy and reproducibility but also standardize imaging parameters.
文摘AIM To perform a systematic review and meta-analysis for the diagnostic accuracy of in vivo lesion characterization in colonic inflammatory bowel disease(IBD), using optical imaging techniques, including virtual chromoendoscopy(VCE), dye-based chromoendoscopy(DBC), magnification endoscopy and confocal laser endomicroscopy(CLE). METHODS We searched Medline, Embase and the Cochrane library. We performed a bivariate meta-analysis to calculate the pooled estimate sensitivities, specificities, positive and negative likelihood ratios(+LHR,-LHR), diagnostic odds ratios(DOR), and area under the SROC curve(AUSROC) for each technology group. A subgroup analysis was performed to investigate differences in real-time nonmagnified Kudo pit patterns(with VCE and DBC) and real-time CLE.RESULTS We included 22 studies [1491 patients; 4674 polyps, of which 539(11.5%) were neoplastic]. Real-time CLE had a pooled sensitivity of 91%(95%CI: 66%-98%), specificity of 97%(95%CI: 94%-98%), and an AUSROC of 0.98(95%CI: 0.97-0.99). Magnification endoscopy had a pooled sensitivity of 90%(95%CI: 77%-96%)and specificity of 87%(95%CI: 81%-91%). VCE had a pooled sensitivity of 86%(95%CI: 62%-95%) and specificity of 87%(95%CI: 72%-95%). DBC had a pooled sensitivity of 67%(95%CI: 44%-84%) and specificity of 86%(95%CI: 72%-94%). CONCLUSION Real-time CLE is a highly accurate technology for differentiating neoplastic from non-neoplastic lesions in patients with colonic IBD. However, most CLE studies were performed by single expert users within tertiary centres, potentially confounding these results.
基金supported by Beijing Municipal Science&Technology Commission(D101100050010056)National Key Technology R&D Program(20I5BAI13B09)
文摘We evaluated and compared the diagnostic accuracy(DA) of apparent diffusion coefficient(ADC) values with that of lesion-to-liver ADC ratios in the characterization of solid focal liver lesions(FLLs).This prospective study was approved by the Institutional Human Ethics Board,after waiving written informed consent.Diffusion-weighted imaging and other routine magnetic resonance imaging were performed on 142 consecutive patients with suspected liver disease.The mean ADC values and lesion-to-liver ADC ratios were compared between benign and malignant solid FLLs.Receiver operating characteristic analysis was performed.The study participants included 46 patients(28 men,18 women;mean age,52.5 years) with 57 solid FLLs(32 malignant and 25 benign FLLs).The mean ADC values and ADC ratios of benign solid FLLs were significantly higher than those of malignant lesions(P<0.01).The difference between the area under the receiver operating characteristic curve of the ADC values(0.699) and ADC ratios(0.752) was not significant.Our study suggests that the DA of the ADC ratio is not significantly higher than that of ADC in characterizing solid FLLs.
