LI-RADS CT和MRI辅助特征与肝细胞癌和恶性病的关联:一个个体参与者数据元分析
Haben Dawit1, Eric Lam1, Matthew D F McInnes1
1From the Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (H.D.); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (H.D., M.D.F.M., J.P.S.); Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (E.L.); Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada (M.D.F.M.); Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (C.B.v.d.P.); Department of Radiology (M.R.B., B.C.A.) and Center for Advanced Magnetic Resonance Development (M.R.B.), Duke University Medical Center, Durham, NC; Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada (J.P.S.); Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada (B.L.); Liver Imaging Group, Department of Radiology, University of California-San Diego, San Diego, Calif (C.B.S.); Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY (V.C.); Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.H.C., S.Y.K.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (T.J.F.); Department of Radiology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (A.T.); Department of Radiology, West China Hospital, Sichuan University, Chengdu, China (H.J., B.S.); Department of Radiology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (J.W.); University of Calgary Foothills Medical Centre, Calgary, Alberta, Canada (S.R.W.); Department of Radiology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea (H.K.); Weill Cornell Medical Center, New York, NY (A.S.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea (I.J.); Department of Radiology, Assistance Publique-Hôpitaux de Paris, Nord, Université Paris Cité, CRI UMR 1149, Paris, France (M.R.); Hôpital Beaujon, Clichy, France (M.R.); Department of Radiology, Chonbuk National University Medical School and Hospital, Jeonju, Republic of Korea (J.S.S.); Second Radiology Department, Warsaw Medical University, Warsaw, Poland (J.P., G.R.); Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Z.K.); and Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Victoria General Building, 3rd Fl, 1276 S Park St, Halifax, NS, Canada B3H 2Y9 (A.F.C.).
大多数肝脏成像报告和数据系统 (LI-RADS) 辅助特征 (AF) 独立预测肝细胞癌 (HCC) 和恶性瘤. 这一元分析澄清了LI-RADS AFs在肝损伤特征的诊断价值.
科学领域:
- 放射学 放射学是一门学科.
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
背景情况:
- 每个肝脏成像报告和数据系统 (LI-RADS) 计算机断层扫描 (CT) 或磁共振成像 (MRI) 辅助特征 (AF) 的独立诊断贡献仍然不清楚.
- 这项研究旨在评估LI-RADS AF与肝细胞癌 (HCC) 和恶性瘤的相关性,并根据LI-RADS的主要特征进行调整.
研究的目的:
- 评估LI-RADS AFs与HCC和恶性瘤的独立关联.
- 用个人参与者数据 (IPD) 的元分析来调整LI-RADS的主要特征.
主要方法:
- 使用2014年1月至2022年1月期间发表的研究数据进行了IPD元分析.
- 搜索的数据库包括Medline,Embase,Cochrane控制试验中央注册表和Scopus.
- 多变量后勤回归模型被用来推导每个AF的调整赔率比率 (ORs),控制主要特征.
主要成果:
- 大多数 (89%) 有利于恶性瘤的AF与恶性瘤和/或HCC相关;80%的有利于HCC的AF与HCC相关.
- 非增强囊 (OR=3.50) 与HCC的关联最强,而扩散限制 (OR=14.45) 和轻度至中度T2高强度 (OR=10.18) 与恶性瘤有很强的关联.
- 平行血池增强 (OR=0.07) 和明显的T2高强度 (OR=0.18) 显示出与HCC最强的负相关性.
结论:
- 大多数LI-RADS AF显示与HCC,恶性或良性的独立关联,支持它们在肝损伤特征中的预期作用.
- 这些发现提高了对特定AF对LI-RADS分类准确性的贡献的理解.
- 尽管在许多纳入的研究中存在高偏差风险,但这些结果为LI-RADS辅助特征的独立价值提供了宝贵的见解.
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