scholarly journals Effectiveness of contrast-enhanced ultrasound for detecting the staging and grading of bladder cancer: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Xinyue Ge ◽  
Zhong-Kai Lan ◽  
Jing Chen ◽  
Shang-Yong Zhu
Keyword(s):  
Bladder Cancer ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Cochrane Library ◽  
Forest Plot ◽  
Low Grade ◽  
High Grade ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced

Aim: The study retrospectively analysed the accuracy of preoperative contrast-enhanced ultrasound (CEUS) in differenti-ating stage Ta-T1 or low-grade bladder cancer (BC) from stage T2 or high-grade bladder cancer. Material and methods: We systematically searched the literature indexed in PubMed, Embase, and the Cochrane Library for original diagnostic articles of bladder cancer. The diagnostic accuracy of CEUS was compared with cystoscopy and/or transurethral resection of bladder tumors (TURBT). The bivariate logistic regression model was used for data pooling, couple forest plot, diagnostic odds ratio (DOR) and summary receiver operating characteristic (SROC). Results: Five studies met the selection criteria; the overall number of reported bladder cancers patients were 436. The pooled-sensitivity (P-SEN), pooled-specificity (P-SPE), pooled-positive likelihood ratio (PLR+), pooled-negative likelihood ratio (PLR−), DOR, and area under the SROC curve were 94.0% (95%CI: 85%–98%), 90% (95%CI: 83%–95%), 9.5 (95%CI: 5.1–17.6), 0.06 (95%CI: 0.02–0.17), 147 (95%CI: 35–612) and 97% (95% CI: 95%–98%) respectively. Conclusion: CEUS reaches a high efficiency in discriminating Ta-T1 or low-grade bladder cancer from stage T2 or high-grade bladder cancer. It can be a promising method in patients to distinguish T staging and grading of bladder cancer because of its high sensitivity, specificity and diagnostic accuracy.

Differentiation between hepatocellular carcinoma and intrahepatic cholangiocarcinoma using contrast-enhanced ultrasound: A systematic review and meta-analysis

2021 ◽  
pp. 1-17
Author(s):  
Yanling Chen ◽  
Wenping Wang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Publication Bias ◽  
Likelihood Ratio ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cochrane Library ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Diagnostic Ability ◽  
Contrast Enhanced

AIM: To explore the diagnostic ability of contrast-enhanced ultrasound (CEUS) in distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). MATERIALS AND METHODS: PubMed, EMBASE, Cochrane Library, and Web of Science were systematically searched for studies reporting the diagnostic accuracy of CEUS in differentiating ICC from HCC. The diagnostic ability of CEUS was assessed based on the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the curve (AUC) with 95% confidence intervals (CIs). The methodologic quality was assessed by the QUADAS-2 tool. Subgroup analyses, meta-regression and investigation of publication bias were performed to identify the source of heterogeneity. RESULTS: A total of eight studies were included, consisting of 1,116 patients with HCC and 529 with ICC. The general diagnostic performance of CEUS in distinguishing ICC and HCC were as follows: pooled sensitivity, 0.92 (95% CI: 0.84–0.96); pooled specificity, 0.87 (95% CI: 0.79–0.92); pooled PLR, 7.1 (95% CI: 4.1–12.0); pooled NLR, 0.09 (95% CI: 0.05–0.19); pooled DOR, 76 (95% CI: 26–220) and AUC, 0.95(95% CI: 0.93–0.97). Different liver background may be a potential factor that influenced the diagnostic accuracy of CEUS according to the subgroup analysis, with the pooled DOR of 89.67 in the mixed liver background group and 46.87 in the cirrhosis group, respectively. Six informative CEUS features that may help differentiate HCC from ICC were extracted. The three CEUS features favoring HCC were arterial phase hyperenhancement(APHE), mild washout and late washout (>60s); the three CEUS favoring ICC were arterial rim enhancement, marked washout and early washout(<60s). No potential publication bias was observed. CONCLUSION: CEUS showed great diagnostic ability in differentiating ICC from HCC, which may be promising for noninvasive evaluation of these diseases.

scholarly journals Diagnostic accuracy of computed tomography angiography (CTA) for diagnosing blunt cerebrovascular injury in trauma patients: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Charlotte C. Kik ◽  
Willem-Bart M. Slooff ◽  
Nizar Moayeri ◽  
Pim A. de Jong ◽  
Sander P. J. Muijs ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Odds Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Low Grade ◽  
Trauma Patients ◽  
Low Sensitivity

Abstract Objectives Previous literature showed that the diagnostic accuracy of computed tomographic angiography (CTA) is not equally comparable with that of the rarely used golden standard of digital subtraction angiography (DSA) for detecting blunt cerebrovascular injuries (BCVI) in trauma patients. However, advances in CTA technology may prove CTA to become equally accurate. This study investigated the diagnostic accuracy of CTA in detecting BCVI in comparison with DSA in trauma patients. Methods An electronic database search was performed in PubMed, EMBASE, and Cochrane Library. Summary estimates of sensitivity, specificity, positive and negative likelihood, diagnostic odds ratio, and 95% confidence intervals were determined using a bivariate random-effects model. Results Of the 3293 studies identified, 9 met the inclusion criteria. Pooled sensitivity was 64% (95% CI, 53–74%) and specificity 95% (95% CI, 87–99%) The estimated positive likelihood ratio was 11.8 (95%, 5.6–24.9), with a negative likelihood ratio of 0.38 (95%, 0.30–0.49) and a diagnostic odds ratio of 31 (95%, 17–56). Conclusion CTA has reasonable specificity but low sensitivity when compared to DSA in diagnosing any BCVI. An increase in channels to 64 slices did not yield better sensitivity. There is a risk for underdiagnosis of BCVI when only using DSA to confirm CTA-positive cases, especially in those patients with low-grade injuries. Key Points • Low sensitivity and high specificity were seen in identifying BCVI with CTA as compared to DSA. • Increased CTA detector channels (≤ 64) did not lead to higher sensitivity when detecting BCVI. • The use of CTA instead of DSA may lead to underdiagnosis and, consequently, undertreatment of BCVI.

scholarly journals The Diagnostic Value of LncRNAs for Bladder Cancer: A Meta-Analysis

2021 ◽  
Author(s):  
Yuan Chen ◽  
Faiza Naz ◽  
Shi Fu ◽  
Mengran Shi ◽  
Haihao Li ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Cochrane Library

Abstract Background: In recent years, qualitative and quantitative analysis of LncRNA has been reported as a potential method for early diagnosis of bladder cancer, but the results from each research are insufficient and not completely consistent. This meta-analysis aims to evaluate the diagnostic value of LncRNA for BC.Methods: We conducted a diagnostic meta-analysis and the diagnostic significance of LncRNA in blood, urine and tumor tissues was discussed. We searched the PUBMED, EMABASE, and Cochrane Library until June 2020. The current meta-analysis was performed using Review Manager 5.2, Stata 16.0 and Meta-Disc 1.4 software. Results: A total of 18 researches involving early and/or advanced bladder cancer were finally included. The overall diagnostic accuracy was measured as follows: pooled sensitivity and specificity were 0.72 (95%CI:0.70, 0.73) and 0.76 (95%CI: 0.75, 0.78). Pooled positive likelihood ratio and negative likelihood ratio were 3.09 (95%CI: 2.66, 3.58) and 0.37 (95%CI: 0.33, 0.42). Combined diagnostic odds ratio was 9.43 (95%CI: 7.30, 12.20). A high diagnostic accuracy was demonstrated by the summary receiver operating characteristic curve, with area under the curve of 0.82 (95%CI: 0.78, 0.85). UCA1 and H19 had the best diagnostic effect, their diagnostic sensitivity and specificity were 80%, 79% and 79%, 73% respectively, the combined diagnostic odds ratio was 16.85 and 12.67 respectively.Conclusions: This meta-analysis suggests that LncRNA have great potential in the diagnosis of bladder cancer, UCA1 and H19 had the best diagnostic effect. LncRNA panel is the future development direction in the diagnosis of bladder cancer. However, larger sample researches are needed to further confirm our conclusion.

scholarly journals Salivary DNA Methylation as an Epigenetic Biomarker for Head and Neck Cancer. Part I: A Diagnostic Accuracy Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 568
Author(s):  
Óscar Rapado-González ◽  
Cristina Martínez-Reglero ◽  
Ángel Salgado-Barreira ◽  
Laura Muinelo-Romay ◽  
Juan Muinelo-Lorenzo ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Head And Neck Cancer ◽  
Diagnostic Accuracy ◽  
Head And Neck ◽  
Likelihood Ratio ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Epigenetic Mechanism ◽  
Cochrane Library

DNA hypermethylation is an important epigenetic mechanism for gene expression inactivation in head and neck cancer (HNC). Saliva has emerged as a novel liquid biopsy representing a potential source of biomarkers. We performed a comprehensive meta-analysis to evaluate the overall diagnostic accuracy of salivary DNA methylation for detecting HNC. PubMed EMBASE, Web of Science, LILACS, and the Cochrane Library were searched. Study quality was assessed by the Quality Assessment for Studies of Diagnostic Accuracy-2, and sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (dOR), and their corresponding 95% confidence intervals (CIs) were calculated using a bivariate random-effect meta-analysis model. Meta-regression and subgroup analyses were performed to assess heterogeneity. Eighty-four study units from 18 articles with 8368 subjects were included. The pooled sensitivity and specificity of salivary DNA methylation were 0.39 and 0.87, respectively, while PLR and NLR were 3.68 and 0.63, respectively. The overall area under the curve (AUC) was 0.81 and the dOR was 8.34. The combination of methylated genes showed higher diagnostic accuracy (AUC, 0.92 and dOR, 36.97) than individual gene analysis (AUC, 0.77 and dOR, 6.02). These findings provide evidence regarding the potential clinical application of salivary DNA methylation for HNC diagnosis.

scholarly journals Diagnostic accuracy of transthoracic echocardiography for pulmonary hypertension: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033084 ◽  
Author(s):  
Jin-Rong Ni ◽  
Pei-Jing Yan ◽  
Shi-Dong Liu ◽  
Yuan Hu ◽  
Ke-Hu Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Hypertension ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Transthoracic Echocardiography ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Cochrane Library ◽  
Lower Sensitivity ◽  
Time Interval

ObjectiveTo evaluate the diagnostic accuracy of transthoracic echocardiography (TTE) in patients with pulmonary hypertension (PH).DesignSystematic review and meta-analysis.Data sources and eligibility criteriaEmbase, Cochrane Library for clinical trials, PubMed and Web of Science were used to search studies from inception to 19 June, 2019. Studies using both TTE and right heart catheterisation (RHC) to diagnose PH were included.Main resultsA total of 27 studies involving 4386 subjects were considered as eligible for analysis. TTE had a pooled sensitivity of 85%, a pooled specificity of 74%, a pooled positive likelihood ratio of 3.2, a pooled negative likelihood ratio of 0.20, a pooled diagnostic OR of 16 and finally an area under the summary receiver operating characteristic curve of 0.88. The subgroup with the shortest time interval between TTE and RHC had the best diagnostic effect, with sensitivity, specificity and area under the curve (AUC) of 88%, 90% and 0.94, respectively. TTE had lower sensitivity (81%), specificity (61%) and AUC (0.73) in the subgroup of patients with definite lung diseases. Subgroup analysis also showed that different thresholds of TTE resulted in a different diagnostic performance in the diagnosis of PH.ConclusionTTE has a clinical value in diagnosing PH, although it cannot yet replace RHC considered as the gold standard. The accuracy of TTE may be improved by shortening the time interval between TTE and RHC and by developing an appropriate threshold. TTE may not be suitable to assess pulmonary arterial pressure in patients with pulmonary diseases.PROSPERO registration numberPROSPERO CRD42019123289.

scholarly journals Blood-Based Circulating MicroRNAs are Potential Diagnostic Biomarkers for Leukemia: Result from a Meta-Analysis

2016 ◽  
Vol 38 (3) ◽  
pp. 939-949 ◽  
Author(s):  
Li-hua Xu ◽  
Yang Guo ◽  
Xue-Li Zhang ◽  
Jia-jia Chen ◽  
Shao-yan Hu
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Circulating Mirnas ◽  
Diagnostic Biomarkers ◽  
Circulating Micrornas

Aims: Circulating microRNAs (miRNAs) as biomarkers for leukemia have been validated by emerging studies. This meta-analysis aims to estimate the overall diagnostic accuracy of blood-based circulating miRNAs for leukemia. Methods: We searched multiple databases (PubMed, EMBASE, Cochrane Library, CNKI, Wan Fang Data and CQVIP) up to June 18, 2015. Results: 32 studies from 10 publications were included in this meta-analysis. Diagnostic capacity was evaluated by pooled sensitivity, specifIcity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) through random-effects model. Sensitivity analyses were sequentially performed to find potential sources of heterogeneity. The quality of included studies was assessed by QUADAS (quality assessment for studies of diagnostic accuracy). Meta-Disc 1.4 and Stata 12.0 software were used to perform the meta-analysis. A high diagnostic accuracy was displayed, with a sensitivity of 0.84, a specificity of 0.88, a PLR of 7.20, a NLR of 0.18, a DOR of 52, and an AUC of 0.94. Subgroup analyses revealed better performance for combined miRNAs, acute myeloid leukemia patients and Asian population than other subgroups. Conclusion: Our analyses suggested that blood-based circulating miRNAs are promising diagnostic biomarkers for leukemia, especially combined miRNAs. Its clinical application awaits further study.

scholarly journals Pooled analysis of Xpert Bladder Cancer based on the 5 mRNAs for rapid diagnosis of bladder carcinoma

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ye-Ling Liu ◽  
Xue-Lin Wang ◽  
Xiao-Hui Yang ◽  
Xiao-Huan Wu ◽  
Guo-Xin He ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Publication Bias ◽  
Likelihood Ratio ◽  
Odds Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Nucleic Acid Amplification ◽  
Cochrane Library ◽  
Target Sequence

Abstract Background Xpert Bladder Cancer is a detection method developed in recent years, designed with the functions of integrating sample automatically, nucleic acid amplification, and target sequence detection. It is a urine assay targeting five mRNAs (CRH, IGF2, UPK1B, ANXA10, and ABL1). The purpose of this article is to review the accuracy of Xpert Bladder Cancer in the follow-up diagnosis of bladder cancer and evaluate the role of Xpert Bladder Cancer in detecting the recurrence of non-muscle-invasive bladder cancer in the round. Methods In the database of Embase, PubMed, Web of Science, and Cochrane Library, the articles published up to October 13, 2020, were searched and screened based on the exclusion and inclusion criteria, and data were extracted from the included studies. The sensitivity, specificity, negative likelihood ratio, positive likelihood ratio summary of receiver operating characteristic curves, and diagnostic odds ratio were combined by the Meta-DiSc 1.4 software. The Stata 12.0 software was used to obtain the assessment of publication bias. Results A total of 8 articles involving eight fourfold tables were finally identified. The pooled sensitivity and specificity of Xpert Bladder Cancer in the diagnosis of bladder cancer were 0.71 and 0.81, respectively. The positive likelihood ratio and negative likelihood ratio were 3.74 and 0.34, respectively. The area under the curve was 0.8407. The diagnostic odds ratio was 11.99. Deeks’ funnel plot asymmetry test manifested no publication bias. Conclusions In summary, Xpert Bladder Cancer presents high accuracy and specificity in monitoring bladder cancer compared with cystoscopy. More researches are still required to further confirm this conclusion.

scholarly journals Comparison of contrast-enhanced ultrasound with MRI in the diagnosis of complex cystic renal masses: a meta-analysis

2018 ◽  
Vol 59 (10) ◽  
pp. 1254-1263 ◽  
Author(s):  
Linli Zhou ◽  
Lemin Tang ◽  
Tao Yang ◽  
Wei Chen
Keyword(s):  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Contrast Enhanced Ultrasound ◽  
Diagnostic Efficacy ◽  
Renal Masses ◽  
Contrast Enhanced ◽  
Sensitivity Specificity

Background The differential diagnosis of cystic renal masses still faces great challenges. There has been no systematically assessment to compare the value of contrast-enhanced ultrasound (CEUS) with magnetic resonance imaging (MRI) in the diagnosis of cystic renal masses. Purpose To perform a meta-analysis to compare the diagnostic efficacy of CEUS with that of MRI for cystic renal masses. Material and Methods A systematic search was performed for literature evaluating the diagnostic performance of CEUS or MRI in cystic renal masses. Quality assessment of diagnostic studies 2 (QUADAS-2) was used to evaluate the quality of each study included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the areas under the summary receiver operating characteristic (AUCs-SROC) curve for CEUS and MRI were calculated, respectively. Results Seventeen studies with 1142 lesions were included. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for CEUS /MRI were 0.95/0.92, 0.84/0.91, 5.62/6.74, and 0.09/0.13, respectively. The AUCs-SROC curves for the two methods were 95.66% and 94.65%. The subgroup analysis indicated that the scanning slice thickness may influence the diagnostic efficacy of MRI. Conclusion Both CEUS and MRI have good diagnostic performance for cystic renal masses and can provide the reference for clinicians. CEUS is more sensitive but less specific than MRI.

scholarly journals A Meta-Analysis of the Diagnostic Accuracy of Circular RNAs in Digestive System Malignancy

2018 ◽  
Vol 45 (3) ◽  
pp. 962-972 ◽  
Author(s):  
Zhiqiang Chen ◽  
Long Zhang ◽  
Guoyong Han ◽  
Xueliang Zuo ◽  
Yao Zhang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Digestive System ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Circular Rnas ◽  
Cancer Type ◽  
Discriminative Ability

Background/Aims: Circular RNAs (circRNAs), a novel class of noncoding RNAs, have been found to be dysregulated in various cancers. However, the clinical application value of these circRNAs in digestive system cancers remains to be clarified. We aimed to comprehensively explore the potential role of circRNAs as diagnostic indicators in digestive system malignancies. Methods: Relevant studies were systematically retrieved from PubMed, Web of Science and the Cochrane Library. The data that were required to complete 2 × 2 contingency tables were obtained from the included studies. Stratified analyses by cancer type, sample size and publication year were performed. Results: Thirteen studies with 2,276 individuals were included in the meta-analysis. The pooled sensitivity and specificity of circRNAs in the diagnosis of digestive system malignancy were 0.72 [95% confidence interval (CI): 0.65-0.77] and 0.77 (95% CI: 0.72-0.81), respectively. The overall positive likelihood ratio was 3.09 (95% CI: 2.64-3.62), and the overall negative likelihood ratio was 0.37 (95% CI: 0.31-0.44). The pooled diagnostic odds ratio was 8.38 (95% CI: 6.86-10.25), and the overall area under the curve was 0.81 (95% CI: 0.77-0.84), indicating good discriminative ability of circRNAs as biomarkers for digestive system malignancy. Conclusion: circRNAs distinguish patients with digestive system cancer from controls with relatively high diagnostic accuracy. circRNAs may be used as potential biomarkers for the diagnosis of digestive system malignancy.

scholarly journals Diagnostic Accuracy of Monofilament Tests for Detecting Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Fengyi Wang ◽  
Jiaqi Zhang ◽  
Jiadan Yu ◽  
Shaxin Liu ◽  
Rengang Zhang ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Diabetic Peripheral Neuropathy ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Operating Characteristics ◽  
Qualitative Synthesis

Objective. To systematically evaluate the diagnostic accuracy of monofilament tests for detecting diabetic peripheral neuropathy. Methods. We searched EMBASE (OvidSP), MEDLINE (OvidSP), the Cochrane Library, and Web of Science to identify diagnostic accuracy trials of monofilament tests for detecting diabetic peripheral neuropathy. We used a hierarchical summary receiver operating characteristics (HSROC) model to conduct the meta-analysis of diagnostic accuracy of monofilament tests for detecting diabetic peripheral neuropathy. Results. A total of 19 comparative trials met the inclusion criteria and were part of the qualitative synthesis. Eight trials using nerve conduction studies as the reference standard were selected for the meta-analysis. The pooled sensitivity and specificity of monofilament tests for detecting diabetic peripheral neuropathy were 0.53 (95% confidence interval (CI) 0.32 to 0.74) and 0.88 (95% CI 0.78 to 0.94), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 4.56 (95% CI 2.93 to 7.10) and 0.53 (95% CI 0.35 to 0.81), respectively. Conclusions. Our review indicated that monofilament tests had limited sensitivity for screening diabetic peripheral neuropathy. The clinical use of the monofilament test in the evaluation of diabetic peripheral neuropathy cannot be encouraged based on currently available evidence.

Sign in / Sign up

Export Citation Format

Share Document