Correlation between CEUS LI-RADS categorization of HCC < 20 mm and clinic-pathological features

Daohui Yang ¹, Xuejun Chen ¹, Linjin Huang ¹

⁰Department of Ultrasound, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China.

Insights Into Imaging +

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May 7, 2024

View abstract on PubMed

Summary

Contrast-enhanced ultrasound (CEUS) LI-RADS is valuable for diagnosing small liver nodules (<20mm) suspicious for hepatocellular carcinoma (HCC). Combining CEUS LI-RADS with clinic-pathological features improves diagnostic accuracy for HCC.

Area Of Science

Radiology
Hepatology
Oncology

Background

Small liver nodules (<20mm) pose diagnostic challenges for hepatocellular carcinoma (HCC).
Contrast-enhanced ultrasound (CEUS) with LI-RADS (Liver Imaging Reporting and Data System) is used for HCC assessment.
Accurate characterization of small nodules is crucial for timely treatment and improved patient outcomes.

Purpose Of The Study

To evaluate the diagnostic performance of CEUS LI-RADS for liver nodules <20mm at high risk for HCC.
To assess the correlation between CEUS LI-RADS categories and clinic-pathological features.
To determine if combining clinic-pathological data improves diagnostic accuracy.

Main Methods

Retrospective analysis of 432 pathologically proven liver nodules <20mm.
Nodules categorized using CEUS LI-RADS (LR-1 to LR-5, LR-M).
Evaluation of sensitivity, specificity, PPV, NPV, and AUC against pathological standards; correlation with clinic-pathological features.

Main Results

CEUS LI-RADS LR-5 showed 50.3% sensitivity and 70.0% specificity for HCC.
Combining clinic-pathological features and imaging criteria (e.g., APHE, washout) improved LR-5 performance (sensitivity 60.2%, AUC 0.651).
Nodule size, HCC history, and differentiation grade influenced CEUS LI-RADS categorization and features.

Conclusions

CEUS LI-RADS is a valuable tool for diagnosing small HCC (<20mm).
Integrating clinic-pathological features with CEUS LI-RADS enhances diagnostic performance.
Further research is warranted to refine its utility in this specific nodule size range.

Keywords:

Contrast media Diagnosis Hepatocellular carcinoma Ultrasound