Related Experiment Videos
Liver Imaging Reporting and Data System on CT and gadoxetic acid-enhanced MRI with diffusion-weighted imaging
Dong Ik Cha1, Kyung Mi Jang2, Seong Hyun Kim1
1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul, 06351, Republic of Korea.
Objectives:
To assess major imaging features of Liver Imaging Reporting and Data System (LI-RADS) on contrast-enhanced CT and gadoxetic acid-enhanced MRI and to estimate whether the combination of signal intensity favouring HCC on hepatobiliary phase (HBP) and diffusion-weighted images (DWI) can act as a major feature in LI-RADS.
Methods:
Four hundred twenty one patients with 445 observations were included. Major features of LI-RADS on CT and MRI as well as HBP and DWI features were assessed. Diagnostic performances of LR-5 according to LI-RADS v2014 and modified LI-RADS which incorporate combination of HBP and DWI were assessed. Pairwise comparisons of the receiver operating characteristic (ROC) curves were performed.
Results:
For HCCs, capsule appearance had the highest rate of discordance between CT and MRI (32.7%), followed by washout appearance (22.2%). Specificity (75%) of LR-5 of LI-RADS v2014 was lower than that (77.1-79.2%) of modified LI-RADS. Area under the ROC curve of modified LI-RADS (0.755-0.775) was not significantly different from that of LI-RADS v 2014 (0.709) (p > 0.05).
Conclusions:
There were substantial discordances between CT and MRI for capsule and washout appearances in hepatic observations, and combination of gadoxetic acid-enhanced MRI and DWI might be able to be incorporated as a major feature of LI-RADS.
Key Points:
• Major imaging features of LI-RADS showed substantial discordances on CT and MRI. • An observation may be categorized differently depending on used imaging exam. • CT and MRI should both be performed for LR-3 and LR-4 observations. • Combination of gadoxetic acid-enhanced MRI and DWI may be a major feature.