A protocol for systematic review and meta-analysis

Background: Microvascular invasion is an independent risk factor for the recurrence of hepatocellular carcinoma (HCC). Early detection and timely treatment can reduce the recurrence and prolong the overall survival of HCC. Contrast-enhanced ultrasound (CEUS) has been validated for their predictive potential of microvascular invasion in HCC patients, although the conclusion remains controversial. Therefore, a meta-analysis is necessary to be conducted to validate the diagnostic value of CEUS for microvascular invasion in HCC, thus supporting guideline development and clinical practice. Methods:Relevant studies reporting the potential diagnostic value of CEUS for microvascular invasion in HCC patients published before February 2022will be searched in the PubMed, EMBASE, Cochrane Library, andWeb of Science. Data will be extracted by 2 researchers independently. The risk of bias will be assessed by the Quality Assessment of Diagnostic Accuracy Studies-2. All of the above statistical analysis will be carried out with Stata 14.0. Results: The results of this study will be published in a peer-reviewed journal. Conclusion: This study will comprehensively evaluate the diagnostic accuracy of CEUS for microvascular invasion in HCC patients, thus providing high-quality evidence to support clinical practice and guideline development. Abbreviations: CEUS = contrast-enhanced ultrasound, HCC = hepatocellular carcinoma.