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Updated: Jun 28, 2026
05:37
An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
LI-RADS v2018 versus KLCA-NCC v2022: comparison of probability-based HCC categories
Jeong Hee Yoon1,2, Eun Sun Lee3, Young Kon Kim4
1Department of Radiology, Seoul National University Hospital, Seoul, 03080, Republic of Korea.
European Radiology
|June 26, 2026
Summary
Comparing diagnostic categories for hepatocellular carcinoma (HCC) in LI-RADS v2018 and KLCA-NCC v2022, this study found both systems effective but not interchangeable. Performance varied by imaging modality, suggesting a need for modality-specific criteria refinement.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Accurate hepatocellular carcinoma (HCC) diagnosis is crucial for patient management.
- Established imaging criteria, such as LI-RADS and KLCA-NCC, aid in risk stratification.
- Comparing these systems is essential for optimizing diagnostic performance.
Purpose of the Study:
- To compare the diagnostic performance of probability-based categories between LI-RADS v2018 and KLCA-NCC v2022.
- To evaluate the interchangeability of corresponding categories across different imaging modalities.
Main Methods:
- Retrospective multicenter study of treatment-naïve patients at risk for HCC.
- Gadoxetic acid-enhanced MRI and CT data evaluated by four independent radiologists.
- Lesions categorized using both LI-RADS v2018 and KLCA-NCC v2022 criteria.
- Pathology or clinical diagnosis served as the reference standard.
Main Results:
- On MRI, LI-RADS LR-5 had a higher positive predictive value (PPV) than KLCA-NCC 'definite HCC' (93.9% vs. 91.7%).
- On CT, KLCA-NCC 'probable HCC' showed higher PPV than LI-RADS LR-4 (83.8% vs. 73.9%).
- Category performance differed significantly between MRI and CT for both systems.
Conclusions:
- Both LI-RADS v2018 and KLCA-NCC v2022 effectively stratify HCC risk.
- Corresponding probability categories are not interchangeable between the two systems.
- Modality-specific performance differences necessitate refinement of CT-specific criteria for improved diagnostic precision.
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