Imaging features of hepatocellular carcinoma compared to intrahepatic cholangiocarcinoma and combined tumor on MRI using liver imaging and data system (LI-RADS) version 2014 Journal Article


Authors: Horvat, N.; Nikolovski, I.; Long, N.; Gerst, S.; Zheng, J.; Pak, L. M.; Simpson, A.; Zheng, J.; Capanu, M.; Jarnagin, W. R.; Mannelli, L.; Do, R. K. G.
Article Title: Imaging features of hepatocellular carcinoma compared to intrahepatic cholangiocarcinoma and combined tumor on MRI using liver imaging and data system (LI-RADS) version 2014
Abstract: Purpose: To evaluate the prevalence of major and ancillary imaging features from liver imaging reporting and data systems (LI-RADS) version 2014 and their interreader agreement when comparing hepatocellular carcinoma (HCC) to intrahepatic cholangiocarcinoma (ICC) and combined tumor (cHCC-CC). Methods: The Institutional Review Board approved this HIPAA-compliant retrospective study and waived the requirement for patients’ informed consent. Patients with resected HCC (n = 51), ICC (n = 40), and cHCC-CC (n = 11) and available pre-operative contrast-enhanced MRI were included from 2000 to 2015. Imaging features and final LI-RADS category were evaluated by four radiologists. Imaging features were compared by Fisher’s exact test and interreader agreements were assessed by κ statistics. Results: None of the features were unique to either HCC or non-HCC. Imaging features that were significantly more common among HCC compared to ICC and cHCC-CC included washout (76%–78% vs. 10%–35%, p < 0.001), capsule (55%–71% vs. 16%–49%, p < 0.05), and intralesional fat (27%–52% vs. 2%–12%, p < 0.002). Features that were more common among ICC and cHCC-CC included peripheral arterial phase hyperenhancement (40%–64% vs. 10%–14%, p < 0.001) and progressive central enhancement (65%–82% vs. 14%–25%, p < 0.001). The interreader agreement was moderate for each of these imaging features (κ = 0.41–0.55). Moderate agreement was also achieved in the assignment of LR-M (κ = 0.53), with an overall sensitivity and specificity for non-HCC malignancy of 86.3% and 78.4%, respectively. Conclusion: HCC and non-HCC show significant differences in the prevalence of imaging features defined by LI-RADS, and are identified by radiologists with moderate interreader agreement. Using LI-RADS, radiologists also achieved moderate interreader agreement in the assignment of the LR-M category. © 2017, Springer Science+Business Media, LLC.
Keywords: adult; controlled study; human tissue; aged; middle aged; major clinical study; histopathology; hepatocellular carcinoma; liver cell carcinoma; liver neoplasms; comparative study; gadolinium; nuclear magnetic resonance imaging; magnetic resonance imaging; sensitivity and specificity; image analysis; tumor volume; prevalence; retrospective study; contrast enhancement; liver tumor; clinical evaluation; intrahepatic cholangiocarcinoma; bile duct carcinoma; cholangiocarcinoma; dynamic contrast-enhanced magnetic resonance imaging; diffusion weighted imaging; fisher exact test; clinical assessment tool; single blind procedure; kappa statistics; artery; picture archiving and communication system; gadoxetic acid; human; male; female; priority journal; article; liver imaging reporting and data system
Journal Title: Abdominal Radiology
Volume: 43
Issue: 1
ISSN: 2366-004X
Publisher: Springer  
Date Published: 2018-01-01
Start Page: 169
End Page: 178
Language: English
DOI: 10.1007/s00261-017-1261-x
PROVIDER: scopus
PUBMED: 28765978
PMCID: PMC6598685
DOI/URL:
Notes: Article -- Export Date: 6 February 2018 -- Source: Scopus
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MSK Authors
  1. Junting Zheng
    200 Zheng
  2. Marinela Capanu
    386 Capanu
  3. Scott R Gerst
    48 Gerst
  4. William R Jarnagin
    905 Jarnagin
  5. Kinh Gian Do
    257 Do
  6. Amber L Simpson
    64 Simpson
  7. Niamh   Long
    18 Long
  8. Linda Ma Pak
    30 Pak
  9. Jian Ying Zheng
    17 Zheng
  10. Natally Horvat
    101 Horvat