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Inter-Reader Agreement for Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System Major Features and

Cristina M Kuon Yeng Escalante1, Tania Siu Xiao1, Yuko Kono2

  • 1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

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|October 29, 2024
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Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) shows substantial agreement for diagnosing hepatocellular carcinoma (HCC). This validates CEUS LI-RADS as a reliable tool for HCC diagnosis in at-risk patients.

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CEUSLI‐RADSagreementinter‐reader

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Area of Science:

  • Radiology
  • Hepatology
  • Oncology

Background:

  • Contrast-enhanced ultrasound (CEUS) with the Liver Imaging Reporting and Data System (LI-RADS) is crucial for diagnosing hepatocellular carcinoma (HCC) in at-risk individuals.
  • Previous validation of CEUS LI-RADS inter-reader variability has been limited in North American and European patient cohorts.

Purpose of the Study:

  • To assess the inter-reader agreement for CEUS LI-RADS features and final categorization of HCC.
  • To validate the reliability of CEUS LI-RADS in North American and European patient populations.

Main Methods:

  • Retrospective analysis of a multinational prospective study database involving 150 liver nodules.
  • Evaluation by site physicians and blinded central readers, with final diagnosis confirmed by a composite reference standard.
  • Inter-reader agreement assessed using Cohen's kappa (κ) statistic.

Main Results:

  • Substantial inter-reader agreement was observed for overall CEUS LI-RADS categorization (κ = 0.61).
  • Agreements were substantial for major features (κ = 0.64–0.78), LR-5 (κ = 0.65), and LR-M (κ = 0.67) categories.
  • Near-perfect agreement was found for LR-1 and LR-2 categories (κ = 0.85).

Conclusions:

  • The study demonstrates substantial inter-reader agreement for CEUS LI-RADS categorization and major HCC imaging features.
  • CEUS LI-RADS is confirmed as a valuable and reliable tool for the diagnosis of HCC in at-risk patients.
  • Findings support the consistent application of CEUS LI-RADS across different readers and centers.