Comparison of LI-RADS 2018 and KLCA-NCC 2018 for noninvasive diagnosis of hepatocellular carcinoma using magnetic resonance imaging

Clinical and Molecular Hepatology - Tập 26 Số 3 - Trang 340-351 - 2020
Sunyoung Lee1, Seung‐seob Kim1, Dong Ryul Chang1, Hyerim Kim2, Myeong‐Jin Kim1
1Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
2Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea

Tóm tắt

Background/Aims: This study aimed to compare the diagnostic performances of Liver Imaging Reporting and Data System (LI-RADS) 2018 and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) 2018 criteria on magnetic resonance imaging (MRI) for the noninvasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients.Methods: This retrospective study included 273 treatment-naïve patients (71 patients with extracellular contrast agent [ECA]-MRI and 202 patients with hepatobiliary agent [HBA]-MRI; 352 lesions including 263 HCCs) with high risk of HCC who underwent contrast-enhanced MRI between 2016 and 2017. Two readers evaluated all lesions according to the criteria of LI-RADS 2018 and KLCA-NCC 2018. The per-lesion diagnostic performances were compared using the generalized estimating equation method.Results: On ECA-MRI, the sensitivity and specificity of LI-RADS 2018 and KLCA-NCC 2018 were not significantly different (LR-5 vs. definite HCC: 75.8% vs. 69.4%, <i>P</i>=0.095 and 95.8% vs. 95.8%, <i>P</i>>0.999; LR-5/4 vs. definite/probable HCC: 87.1% vs.83.9%, P=0.313 and 87.5% vs. 91.7%, <i>P</i>=0.307). On HBA-MRI, definite HCC of KLCA-NCC 2018 showed significantly higher sensitivity (79.1% vs. 68.2%, <i>P</i><0.001) than LR-5 of LI-RADS 2018 without a significant difference in specificity (93.9% vs. 95.4%, <i>P</i>=0.314). Definite/probable HCC of KLCA-NCC 2018 had higher specificity (92.3% vs. 80.0%, <i>P</i>=0.003) than LR-5/4 of LI-RADS 2018. The sensitivity was lower for definite/probable HCC than for LR-5/4 without statistical significance (85.6% vs. 88.1%, <i>P</i>=0.057).Conclusions: On ECA-MRI, LI-RADS 2018 and KLCA-NCC 2018 showed comparable diagnostic performances. On HBA-MRI, definite HCC of KLCA-NCC 2018 provided better sensitivity than LR-5 category of LI-RADS 2018 without compromising the specificity, while definite/probable HCC of KLCA-NCC 2018 revealed higher specificity than LR-5/4 of LI-RADS 2018 for diagnosing HCC.

Từ khóa


Tài liệu tham khảo

10.1016/j.jhep.2018.09.014

10.1002/hep.29913

2018, EASL clinical practice guidelines: management of hepatocellular carcinoma, 182

10.1007/s00261-017-1292-3

10.3350/cmh.2018.0090

Park, 2004, Practice guideline for diagnosis and treatment of hepatocellular carcinoma, 88

2009, Practice guidelines for management of hepatocellular carcinoma 2009, 391

2015, 2014 KLCSG-NCC Korea practice guideline for the management of hepatocellular carcinoma, 267

2019, 2018 Korean Liver Cancer Association-National Cancer Center Korea practice guidelines for the management of hepatocellular carcinoma, 227

2019, 2018 Korean Liver Cancer Association-National Cancer Center Korea practice guidelines for the management of hepatocellular carcinoma, 1042

10.1016/j.jhep.2016.01.018

10.1007/s00330-018-5727-1

10.1148/radiol.2019182587

10.1148/radiol.2018181494

10.1007/s00261-017-1196-2

10.1007/s00330-017-5188-y

10.1016/j.jhep.2017.12.014

10.1136/gutjnl-2019-318555

10.1002/hep.29789

10.1148/radiol.2017170114

10.1007/s00330-018-5605-x

10.1002/hep.30122

Thông tin
Thông tin xuất bản

Clinical and Molecular Hepatology

Tập 26 Số 3

340-351

Thông tin tác giả