# Updates on the Diagnostic Use of Ultrasonography Augmented With Perfluorobutane Contrast in Hepatocellular Carcinoma: A Meta-Analysis

## TL;DR

This study shows that using contrast-enhanced ultrasound with perfluorobutane improves the accuracy of diagnosing liver cancer.

## Contribution

The paper provides updated meta-analysis evidence on the diagnostic accuracy of perfluorobutane-augmented CEUS for hepatocellular carcinoma.

## Key findings

- The pooled sensitivity of perfluorobutane-augmented CEUS was 85.6% and specificity was 91.5%.
- The positive likelihood ratio was 12.42, indicating strong diagnostic value.
- Seven studies clustered near the top left of the SROC curve, showing high diagnostic accuracy.

## Abstract

To investigate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in the diagnosis of primary hepatocellular carcinoma (HCC), a thorough search was conducted for pertinent literature using PubMed, SCOPUS, Web of Science, Science Direct, and Wiley Library. This was a meta-analysis of diagnostic test accuracy. MetaDiSc 1.4 was used for all analyses and assessed statistical heterogeneity with the I2 index and the chi-square test. The random-effects model was applied where there was considerable heterogeneity. Using the eight elements of the Newcastle-Ottawa Scale (NOS) for cohort and case-control studies, we assessed the quality of the included studies. Our results included nine studies with a total of 2598 patients, and 1607 (61.8%) were males. The pooled overall sensitivity of perfluorobutane with CEUS was 85.6% (95% CI 0.832, -0.878, and P=0.000) and specificity was 91.5% (95% CI 0.899, -0.930, and P=0.000) with significant inter heterogeneity between studies (I2=94.3% and 95.7%), respectively. The pooled positive likelihood ratio was 12.42 (4.59 to 33.61, P=0.000). Our analysis revealed a symmetric summary receiver operating characteristic (SROC) curve and seven of the included studies are near the top left corner of the graph, indicating that this test has a high diagnostic value. The results showed that CEUS augmented with perfluorobutane contrast had good diagnostic accuracy (sensitivity and specificity) for primary HCC. Further real-world data studies are needed to confirm the good diagnosis accuracy of perfluorobutane CEUS in primary HCC.