Diagnostic value of contrast-enhanced ultrasound in ovarian cancer: a meta-analysis

Background Ovarian cancer has been reported to be the eighth most common cancer among women worldwide.Purpose To assess the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) in distinguishing between benign and malignant ovarian tumors.Material and Methods A comprehensive search of scientific literature databases, including PubMed, Cochrane Library, Web of Science, Wanfang, and CNKI, was conducted from their inception to November 2019 to identify relevant studies on the use of CEUS in the differential diagnosis of benign and malignant ovarian tumors. Sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (LR+/LR-), diagnostic odds ratios (DORs), and their corresponding 95% confidence intervals (CIs) were retrieved and analyzed using Stata 15.0.Results After rigorous screening, a total of 15 high-quality clinical studies encompassing 934 patients with ovarian cancer, comprising 969 ovarian tumors (403 malignant tumors and 566 benign tumors), were included in the analysis. Data analysis revealed significant correlations between CEUS and various diagnostic indices for ovarian tumors: the combined SEN and SPE were 0.93 (95% CI = 0.88-0.96) and 0.93 (95% CI = 0.90-0.96), respectively, and the combined LR+ and LR- were 14.07 (95% CI = 9.46-20.92) and 0.08 (95% CI = 0.05-0.13), respectively, with a combined DOR of 185.15 (95% CI = 93.31-367.41). The area under the summary receiver operating characteristic curve (AUC) was 0.98 (95% CI = 0.96-0.99). No publication bias was detected in the meta-analysis (P = 0.62).Conclusion CEUS demonstrates significant value in the diagnosis and differential diagnosis of benign and malignant ovarian tumors.