Study on the concordance in the diagnostic efficacy between CEUS LI-RADS and CT/MR LI-RADS for HCC
Peihua Wang1,2,3, Yanqing Wang1,2,3, Guojuan Wang1,2,3
1Ultrasound Medical Center, The Second Hospital of Lanzhou University, Lanzhou, China.
Insights
Contrast-enhanced ultrasound (CEUS) LI-RADS and CT/MRI LI-RADS show general agreement for classifying liver lesions in hepatocellular carcinoma (HCC) patients. Both methods demonstrate high diagnostic performance for HCC, but LR-M
Area of Science:
- Radiology
- Hepatology
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a major global health concern, particularly in patients with chronic liver disease.
- Accurate imaging diagnosis of focal intrahepatic lesions is crucial for timely HCC management.
- Liver Imaging Reporting and Data System (LI-RADS) provides standardized criteria for lesion classification.
Purpose of the Study:
- To compare the diagnostic concordance of contrast-enhanced ultrasound (CEUS) LI-RADS and CT/MRI LI-RADS for intrahepatic lesions.
- To evaluate the diagnostic performance of each modality in patients at high risk for HCC.
Main Methods:
- Retrospective analysis of 165 intrahepatic lesions in high-risk HCC patients from January 2018 to January 2021.
- Classification of lesions using CEUS LI-RADS and CT/MRI LI-RADS.
- Validation against puncture biopsy or surgical pathology, with kappa concordance testing.
Main Results:
- General agreement (kappa = 0.345) was found between CEUS LI-RADS and CT/MRI LI-RADS (P < 0.001).
- Both modalities showed high positive predictive values for HCC using LR-5 (CEUS: 95.4%, CT/MRI: 94.6%).
- CT/MRI LR-M had a significantly higher positive predictive value for non-HCC malignancies (76.5%) compared to CEUS LR-M (34.1%) (P < 0.05).
Conclusions:
- CEUS LI-RADS and CT/MRI LI-RADS demonstrate general concordance in classifying intrahepatic lesions in high-risk HCC patients.
- Both imaging techniques exhibit high diagnostic performance and specificity for HCC when using LR-5.
- The differential diagnostic value of LR-M for distinguishing non-HCC malignancies requires further investigation.
Abstract:
ObjectiveTo investigate the diagnostic concordance between CEUS LI-RADS and CT/MR LI-RADS for focal intrahepatic lesions in patients at high risk of hepatocellular carcinoma.MethodsRetrospective analysis of imaging data of patients at high risk of HCC attending our hospital from January 2018 to January 2021, 165 lesions were classified according to CEUS LI-RADS and CT/MR LI-RADS, respectively, using puncture biopsy or surgical pathology as the criteria. The kappa concordance test was used to evaluate the classification results of intrahepatic focal lesions in high-risk groups.ResultsThe concordance between CEUS and CT/MRI LI-RADS for the classification of intrahepatic focal lesions in the high-risk group of HCC was statistically different (P < 0.001), and the agreement between the two imaging methods was general (kappa = 0.345，P < 0.001). The positive predictive value of CEUS LR-5 for HCC was 95.4%, and the positive predictive value of CT/MRI LR-5 had a positive predictive value of 94.6% for HCC, and the difference between CEUS and CT/MRI LR-5 for HCC was not statistically significant. The positive predictive value of CEUS LR-M for non-HCC malignancies was 34.1%, and the positive predictive value of CT/MRI LR-M for non-HCC malignancies was 76.5%, and the difference between CEUS and CT/MRI LR-M had a statistically significant difference in the positive predictive value for non-HCC malignancies (P < 0.05).ConclusionsThe classification results of CEUS and CT/MRI LI-RADS for focal intrahepatic lesions in a high-risk group of HCC were in general agreement, but both had high diagnostic performance, and both had high specificity and positive predictive value using LR-5 as the diagnostic imaging standard for HCC, while the differential diagnostic value of LR-M for non-HCC malignant tumors and HCC still needs to be further investigated.
