Diagnostic and clinical utility of dynamic contrast-enhanced MR imaging in indeterminate pulmonary nodules: a metaanalysis.

OBJECTIVE: This study aims to perform a metaanalysis to assess the diagnostic performance and clinical utility of the dynamic magnetic resonance imaging (MRI) in discrimination of benign and malignant pulmonary nodules.

MATERIALS AND METHODS: We searched PubMed, EMBASE, and Cochrane Library from January 1995 to May 2015 for studies evaluating the diagnostic accuracy of dynamic MRI in discriminating benign from malignant pulmonary nodules. Methodological quality was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) were calculated. Potential publication bias was investigated.

RESULTS: Twelve studies with 524 malignant and 284 benign nodules were included in this metaanalysis. The publication bias was not significant. Summary receiver operating characteristic curve showed that AUC was 0.94 [95% confidence interval (CI), 0.83-0.98], with pooled sensitivity of 0.95 (95% CI: 0.90, 0.97), specificity of 0.87 (95% CI: 0.72, 0.95), PLR of 7.6 (95% CI: 3.2, 18.0), NLR of 0.06 (95% CI: 0.03, 0.11), and DOR of 133 (95% CI: 45, 393), respectively.

CONCLUSION: Dynamic contrast-enhanced MRI is valuable for discrimination of benign from malignant pulmonary nodules and is especially useful for exclusion of malignant pulmonary nodules.