The Comparative Accuracy of Computed Tomography and Magnetic Resonance Imaging for the Diagnosis of Liver Cirrhosis in Adult Patients: A Structured Literature Review

Abstract

Abstract

Aim and Background

In response to the growing prevalence and burden of cirrhosis, worldwide, with the problem accounting for excess morbidity and mortality; outcomes that can be improved through timely and accurate diagnosis, this structured literature review sought to explore the diagnostic accuracy of CT and MRI. Methods

A search for relevant literature was undertaken in July 2021 using MEDLINE, EMBASE, Open Grey and the Cochrane library. Key terms were applied and eligible studies were limited to publication in the past decade and English language. Evidence quality was appraised using the QUADAS-2 framework and the evidence was synthesised using a narrative and pictorial approach.

Result

7 studies were eligible for inclusion, which were of retrospective and prospective cohort design. QUADAS-2 recognised the varied risks of bias and issues of applicability across the evidence. Overall, the diagnostic accuracy of CT and MRI were similar with sensitivities and specificities varying between 90.0-97.9% and 80.0-84.8%, and between 80-95% and 89-100%, respectively. Variances in accuracy were largely attributed to differences in the CT and MRI protocols employed.

Conclusion MR elastography yielded the most favourable diagnostic accuracy for cirrhosis and thus, it was concluded that this modality could be used to negate the need for liver biopsy and histological diagnosis. The evidence of this review should be interpreted with some caution due to the limitations of the studies included but key implications for ongoing radiological practice and future research in the field were derived