Diagnostic accuracy of Color Doppler ultrasound for detecting portal venous thrombosis in hepatocellular carcinoma patients: A meta-analysis.

e16158 Background: Portal venous thrombosis (PVT) is a frequent and clinically significant complication in patients with hepatocellular carcinoma (HCC), influencing prognosis and therapeutic planning. Color Doppler ultrasound is widely available and often used as an imaging tool. However, its diagnostic performance relative to contrast-enhanced computed tomography (CT) remains uncertain. This meta-analysis aimed to synthesize available evidence on the diagnostic accuracy of Color Doppler in detecting PVT in HCC patients, using CT as the reference. Methods: A systematic literature search of PubMed, Embase, Web of Science, Scopus, Cochrane Library and grey literature from inception to December 2025 was conducted. True-positive, false-positive, false-negative, and true-negative data were extracted to construct 2×2 contingency tables for each study. Analyses were performed using Stata version 17 and R version 4.5.1. Results: Six eligible studies were included (N = 694, mean ages 43.19 ± 7.49 to 58.6 ± 10.2 years). Most patients were male (57.5%). The pooled sensitivity was 0.86 (95% CI 0.80 to 0.91) and specificity was 0.93 (95% CI 0.91 to 0.95). The DOR was 91.2, with LR+ = 13.2 and LR- = 0.14. Conclusions: Color Doppler ultrasound shows high diagnostic accuracy for detecting portal venous thrombosis in hepatocellular carcinoma, with high specificity and sensitivity. These findings indicate towards its utility as a possible first-line, non-invasive screening tool, particularly in resource-limited settings. However, further multicenter studies are needed to confirm generalizability across diverse clinical contexts.