Contrast-enhanced ultrasound Liver Imaging Reporting and Data System category M: a systematic review and meta-analysis
	    		
		   		
		   			
		   		
	    	
    	- Author:
	        		
		        		
		        		
			        		Jaeseung SHIN
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Sunyoung LEE
			        		
			        		;
		        		
		        		
		        		
			        		Yeun-Yoon KIM
			        		
			        		;
		        		
		        		
		        		
			        		Yong Eun CHUNG
			        		
			        		;
		        		
		        		
		        		
			        		Jin-Young CHOI
			        		
			        		;
		        		
		        		
		        		
			        		Mi-Suk PARK
			        		
			        		
		        		
		        		
		        		
			        		
			        		Author Information
			        		
 - Publication Type:13
 - From: Ultrasonography 2022;41(1):74-82
 - CountryRepublic of Korea
 - Language:English
 - 
		        	Abstract:
			       	
			       		
				        
				        	 Purpose:A meta-analysis was conducted to determine the proportion of contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System category M (LR-M) in hepatocellular carcinomas (HCCs) and non-HCC malignancies and to investigate the frequency of individual CEUS LR-M imaging features. 
				        	
Methods:The MEDLINE and Embase databases were searched from January 1, 2016 to July 23, 2020 for studies reporting the proportion of CEUS LR-M in HCC and non-HCC malignancies. The meta-analytic pooled proportions of HCC and non-HCC malignancies in the CEUS LR-M category were calculated. The meta-analytic frequencies of CEUS LR-M imaging features in nonHCC malignancies were also determined. Risk of bias and applicability were evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
Results:Twelve studies reporting the diagnostic performance of the CEUS LR-M category were identified, as well as seven studies reporting the frequencies of individual CEUS LR-M imaging features. The pooled proportions of HCC and non-HCC malignancies in the CEUS LR-M category were 54% (95% confidence interval [CI], 44% to 65%) and 40% (95% CI, 28% to 53%), respectively. The pooled frequencies of individual CEUS LR-M imaging features in non-HCC malignancies were 30% (95% CI, 17% to 45%) for rim arterial phase hyperenhancement, 79% (95% CI, 66% to 90%) for early (<60 s) washout, and 42% (95% CI, 21% to 64%) for marked washout.
Conclusion:In total, 94% of CEUS LR-M lesions were malignancies, with HCCs representing 54% and non-HCC malignancies representing 40%. The frequencies of individual CEUS LR-M imaging features varied; early washout showed the highest frequency for non-HCC malignancies. 
            