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A Multicenter Assessment of Interreader Reliability of LI-RADS Version 2018 for MRI and CT
Cheng William Hong1, Victoria Chernyak1, Jin-Young Choi1
1From the Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Ave, S255, Box 0628, San Francisco, CA 94143 (C.W.H., M.A.O.); Liver Imaging Group, Department of Radiology, University of California, San Diego, San Diego, Calif (C.W.H., C.P., T.D., D.T.M., K.J.F., C.B.S.); Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY (V.C., N.H.); Department of Radiology, Yonsei University, Seoul, South Korea (J.Y.C.); Department of Radiology, University of California Irvine, Orange, Calif (S.L., R.K.); Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, Calif (T.W., A.G.); Department of Radiology, New York University, New York, NY (J.B.); Department of Radiology, University of Florida, Jacksonville, Fla (C.L.); Department of Radiology, University of Kentucky, Lexington, Ky (J.T.L., J.W.O.); Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (D.A.A.); Department of Radiology, University of Michigan, Ann Arbor, Mich (M.M.L., M.S.D., W.M.); Department of Radiology, Allegheny Health Network, Pittsburgh, Pa (A.R.); Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (S.C.L.); Department of Radiology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY (A.S.K., E.M.H.); Departments of Radiology and Medicine, Duke University Medical Center, New York, NY (M.R.B.); Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital Paolo Giaccone, Palermo, Italy (G.B.); Department of Radiology, University of California Los Angeles, Los Angeles, Calif (M.L.D.); Department of Radiology, Radiation Oncology and Nuclear Medicine, Université de Montréal, Montréal, Canada (A.T., M.C.); Department of Radiology, Oregon Health & Science University, Portland, Ore (A.F.); CEDRUL-Centro de Diagnóstico por Imagem, João Pessoa, Brazil (E.A.C.); Department of Radiology, University of California Davis, Sacramento, Calif (M.T.C., J.P.M.); Radiology Limited, Tucson, Ariz (B.K.); Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, Houston, Tex (K.M.E., V.R.S., K.B.); Department of Radiology, Naval Medical Center San Diego, San Diego, Calif (R.M.M.); University of São Paulo/Hospital Sírio-Libanês, São Paulo, Brazil (N.H.); Department of Radiology, University of Kansas, Kansas City, Kan (S.B., R.A.); Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, India (K.G.); Department of Radiology, California Pacific Medical Center, San Francisco, Calif (C.R.K.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (A.K.); The 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (J.W.); Inland Imaging, Spokane, Wash (I.C.); Sutter Medical Group, Sacramento, Calif (B.B.); Austin Health, Melbourne, Australia (M.G.); Department of Radiology, University of Washington, Seattle, Wash (G.M.C.).
Reader agreement for Liver Imaging Reporting and Data System (LI-RADS) showed moderate results overall. Research-versus-research reader agreement surpassed research-versus-clinical agreement in some comparisons, suggesting environmental differences impact assessments.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Previous studies on Liver Imaging Reporting and Data System (LI-RADS) reader agreement faced limitations.
- Standardized reader agreement assessment is crucial for reliable liver lesion characterization.
Purpose of the Study:
- To evaluate LI-RADS reader agreement in an international, multicenter, multireader setting.
- To compare agreement rates between research readers and between research and clinical reads using scrollable images.
Main Methods:
- Retrospective analysis of deidentified multiphase CT and MRI examinations from six institutions across three countries.
- LI-RADS version 2018 categorization was applied to untreated observations, with 43 research readers independently scoring selected cases.
- Agreement was calculated using intraclass correlation coefficients (ICCs) for ordinal and dichotomized LI-RADS categories.
Main Results:
- Moderate agreement was observed for ordinal LI-RADS (ICC=0.68) and dichotomized malignancy (ICC=0.63).
- Research-versus-research reader agreement was significantly higher than research-versus-clinical agreement for ordinal LI-RADS and dichotomized malignancy.
- Agreement for LR-5 (ICC=0.58) and LR-M (ICC=0.46) categories showed lower concordance.
Conclusions:
- LI-RADS version 2018 demonstrates moderate overall reader agreement.
- Differences in agreement between clinical and research settings highlight the need for further investigation into environmental factors.
- Standardized training and image display may improve LI-RADS consistency in clinical practice.
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