Potential role of contrast-enhanced ultrasound for the differentiation of malignant and benign gallbladder lesions in East Asia: A meta-analysis and systematic review

BACKGROUND: The purpose of this study was to systematically review and evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in differentiating malignant and benign gallbladder lesions. METHODS: We conducted a comprehensive search on PubMed, Embase, and Cochrane Library for all potential relevant articles published before December 2017. The pooled sensitivity, specificity, diagnostic odds ratio (DOR) and area under the curve (AUC) of summary receiver operating characteristic (SROC) were calculated by Meta-Disc Version 1.4 and STATA 12.0. RESULTS: Twelve eligible studies were included in our study. A total of 1044 patients were assessed. The pooled sensitivity and specificity were 0.81 (95% confidence interval [CI], 0.77–0.84; inconsistency index [I(2)] = 84.5%) and 0.87 (95% CI, 0.85–0.89; I(2) = 94.4%), respectively. The pooled DOR was 58.84 (95% CI, 32.39–106.88; I(2) = 51.9%). The AUC was 0.9371. According to Deek funnel plot asymmetry test, there was no significant publication bias (P = .31). CONCLUSIONS: The results yielded from the available evidence suggest that CEUS is a promising and adjuvant imaging technique to conventional ultrasound for the differential diagnosis of benign and malignant gallbladder lesions.