Performance of Liver Imaging Reporting and Data System (LI-RADS) nonradiation treatment response algorithm version
Liuji Sheng1, Chongtu Yang1, Yidi Chen1,2
1Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
Background:
The effectiveness of Liver Imaging Reporting and Data System treatment response algorithm version 2024 (LR-TRA v2024) in hepatocellular carcinoma (HCC) patients undergoing locoregional plus systemic combination therapy remains uncertain. We aimed to investigate the performance of LR-TRA v2024 on magnetic resonance imaging (MRI) in detecting residual HCC following transarterial chemoembolization (TACE) plus systemic therapy.
Methods:
This single-center retrospective study included consecutive adult patients who received TACE plus systemic therapy for HCC and subsequent surgical resection (July 2019 to November 2023). All contrast-enhanced preoperative MRIs were independently evaluated by three blinded radiologists for LR-TR, Liver Imaging Reporting and Data System treatment response (LR-TR) categories and two ancillary features. Postoperative pathology was used as the reference standard for residual tumors, which was further categorized as any (>0%) or major (>10%) residual tumors. When investigating the performances of LR-TR categories, the LR-TR Equivocal category was grouped into the LR-TR Viable category. The diagnostic performances were evaluated using positive predicting value (PPV) and negative predicting value (NPV).
Results:
Fifty-one patients (median age, 56 years; 45 males) with 63 HCCs were included. For the detection of any residual tumor, the per-lesion PPV and NPV of the LR-TR Viable category were 100.0% and 46.9%, respectively; the per-patient PPV and NPV were 100.0% and 45.5%, respectively. For the detection of major residual tumor, the per-lesion PPV and NPV of the LR-TR Viable category were 80.6% and 84.4%, respectively; the per-patient PPV and NPV were 82.8% and 86.4%, respectively.
Conclusions:
LR-TRA v2024 was effective in evaluating treatment response and detecting residuals of HCC to TACE plus systemic therapy.
