A modified Rim APHE criterion to improve LI-RADS diagnostic performance for primary liver malignancies

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Primary liver malignancies pose a significant diagnostic challenge.
• Rim arterial phase hyperenhancement (Rim APHE) is a key imaging feature in assessing liver lesions.
• Current diagnostic criteria for Rim APHE may require refinement for improved accuracy.

Purpose of the Study:

• To refine the diagnostic criteria for Rim APHE.
• To evaluate the impact of modified Rim APHE criteria on the diagnostic performance for primary liver malignancies using the Liver Imaging Reporting and Data System (LI-RADS).

Main Methods:

• A multicenter, retrospective study of 272 patients with pathologically confirmed primary liver malignancies.
• Evaluation of thirteen different measurement methods for Rim APHE to determine the optimal criterion.
• Independent review by two radiologists using LI-RADS version 2018, comparing diagnostic performance with original and modified Rim APHE criteria.

Main Results:

• The optimal Rim APHE criterion was defined as the total thickness of the thickest part of peripheral hyperenhancement to tumor diameter (AUC = 0.852).
• Modified Rim APHE criteria significantly improved AUC, sensitivity, and accuracy for LR-5 criteria.
• Modified criteria also led to higher AUC, specificity, and accuracy for LR-M criteria.

Conclusions:

• A refined criterion for Rim APHE enhances diagnostic performance for primary liver malignancies.
• The modified criteria improve the accuracy of LI-RADS for both hepatocellular carcinoma and non-HCC malignancies.
• This refinement offers a more precise tool for diagnosing liver tumors.