{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:21:37Z","timestamp":1789690897776,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T00:00:00Z","timestamp":1702166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australas J Ultrason Med"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Purpose<\/jats:title><jats:p>Patients with cirrhosis and hepatocellular carcinoma (HCC) can develop both benign and malignant portal vein thrombosis (PVT). Characterising the nature of PVT is important for planning an optimal therapeutic strategy. In the absence of typical findings or contraindications to computed tomography (CT) or magnetic resonance imaging (MRI), contrast\u2010enhanced ultrasound (CEUS) could help in this differentiation. The present meta\u2010analysis aimed to evaluate the performance of CEUS for characterising PVT in patients with HCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic databases of PubMed, Embase and Scopus were searched from inception to 31 December 2022 for studies analysing the role of CEUS in the differentiation of benign and malignant PVT in HCC. Using the bivariate random effect model, pooled sensitivity and specificity were calculated, and the summary receiver operating characteristic (sROC) curve was plotted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 12 studies with data from 712 patients were included in the meta\u2010analysis. The pooled sensitivity and specificity of CEUS for the diagnosis of tumour in vein were 97.0% (95% CI: 93.0\u201398.7) and 96.8% (95% CI: 92.1\u201398.7), respectively, without significant heterogeneity. A sROC curve was plotted, and the area under the receiver operating characteristic was 0.99 (95% CI: 0.98\u20131.00). Despite the presence of publication bias, sensitivity analysis did not show any change in sensitivity and specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our meta\u2010analysis summarises the accuracy data from 12 studies, including &gt;700 subjects. Contrast\u2010enhanced ultrasound had excellent diagnostic accuracy with pooled sensitivity and specificity of 97.5% (95% CI: 93.5\u201399.1) and 98.2% (95% CI: 91.5\u201399.6), respectively, without any significant heterogeneity. Additionally, the pooled positive LR, negative LR and DOR were 54.6 (95% CI: 11.1\u201325.6), 0.02 (0.01\u20130.07) and 2186.8 (318.3\u201315022.2), respectively. A positive result increases the pretest probability of malignant PVT from 50% to 98%, whereas a negative result decreases it from 50% to 2%. Most of the studies included in our meta\u2010analysis used identical techniques and 6\u201312\u2010month follow\u2010up scans to check for thrombus progression or regression. Our analysis showed no significant heterogeneity in the studies, and area under receiver operating characteristic curve (AUROC) with 95% CI was 1.00 (95% CI: 0.99\u20131.00). This critical meta\u2010analysis thus propels CEUS to the forefront for differentiating benign from tumoural PVT and suggests routinely using CEUS in patients presenting with HCC and evidence of thrombus on greyscale ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Contrast\u2010enhanced ultrasound is an effective diagnostic modality differentiation of benign and malignant PVT in patients with HCC and can be an alternative modality to CT or MRI. Further studies are required to study the role of CEUS as initial diagnostic modality for the characterisation of PVT in HCC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajum.12375","type":"journal-article","created":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T10:43:55Z","timestamp":1702205035000},"page":"56-64","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Role of contrast\u2010enhanced ultrasound for differentiation of benign vs. malignant portal vein thrombosis in hepatocellular carcinoma \u2013 A\u00a0systematic review a meta\u2010analysis"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9626-5243","authenticated-orcid":false,"given":"Suprabhat","family":"Giri","sequence":"first","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Kalinga Institute of Medical Sciences  Bhubaneswar 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