Liver Imaging Reporting and Data System version 2018 category 5 for diagnosing hepatocellular carcinoma: An updated meta-analysis Journal Article


Authors: Lee, S.; Kim, Y. Y.; Shin, J.; Roh, Y. H.; Choi, J. Y.; Chernyak, V.; Sirlin, C. B.
Article Title: Liver Imaging Reporting and Data System version 2018 category 5 for diagnosing hepatocellular carcinoma: An updated meta-analysis
Abstract: Objective: We performed an updated meta-analysis to determine the diagnostic performance of Liver Imaging Reporting and Data System (LI-RADS, LR) 5 category for hepatocellular carcinoma (HCC) using LI-RADS version 2018 (v2018), and to evaluate differences by imaging modalities and type of MRI contrast material. Methods: The MEDLINE and Embase databases were searched for studies reporting the performance of LR-5 using v2018 for diagnosing HCC. A bivariate random-effects model was used to calculate the pooled per-observation sensitivity and specificity. Subgroup analysis was performed based on imaging modalities and type of MRI contrast material. Results: Forty-eight studies qualified for the meta-analysis, comprising 9031 patients, 10,547 observations, and 7216 HCCs. The pooled per-observation sensitivity and specificity of LR-5 for diagnosing HCC were 66% (95% CI, 61–70%) and 91% (95% CI, 89–93%), respectively. In the subgroup analysis, MRI with extracellular agent (ECA-MRI) showed significantly higher pooled sensitivity (77% [95% CI, 70–82%]) than CT (66% [95% CI, 58–73%]; p = 0.023) or MRI with gadoxetate (Gx-MRI) (65% [95% CI, 60–70%]; p = 0.001), but there was no significant difference between ECA-MRI and MRI with gadobenate (gadobenate-MRI) (73% [95% CI, 61–82%]; p = 0.495). Pooled specificities were 88% (95% CI, 80–93%) for CT, 92% (95% CI, 86–95%) for ECA-MRI, 93% (95% CI, 91–95%) for Gx-MRI, and 91% (95% CI, 84–95%) for gadobenate-MRI without significant differences (p = 0.084–0.803). Conclusions: LI-RADS v2018 LR-5 provides high specificity for HCC diagnosis regardless of modality or contrast material, while ECA-MRI showed higher sensitivity than CT or Gx-MRI. Clinical relevance statement: Refinement of the criteria for improving sensitivity while maintaining high specificity of LR-5 for HCC diagnosis may be an essential future direction. Key Points: • The pooled per-observation sensitivity and specificity of LR-5 for diagnosing HCC using LI-RADSv2018 were 66% and 91%, respectively. • ECA-MRI showed higher sensitivity than CT (77% vs 66%, p = 0.023) or Gx-MRI (77% vs 65%, p = 0.001). • LI-RADS v2018 LR-5 provides high specificity (88–93%) for HCC diagnosis regardless of modality or contrast material type. © The Author(s), under exclusive licence to European Society of Radiology 2023.
Keywords: adult; retrospective studies; liver cell carcinoma; carcinoma, hepatocellular; liver neoplasms; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer diagnosis; sensitivity and specificity; diagnostic imaging; retrospective study; radiology; diagnostic value; systematic review; liver tumor; diagnosis; contrast medium; contrast media; organometallic compound; organometallic compounds; meta analysis; chelating agents; diagnostic test accuracy study; chelating agent; procedures; gadoxetic acid; clinical significance; humans; human; male; female; article; liver neoplasm; meglumine; liver imaging reporting and data system; gadobenic acid
Journal Title: European Radiology
Volume: 34
Issue: 3
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2024-03-01
Start Page: 1502
End Page: 1514
Language: English
DOI: 10.1007/s00330-023-10134-z
PUBMED: 37656177
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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