Comparison between M-score and LR-M in the reporting system of contrast-enhanced ultrasound LI-RADS

Chen, Li-Da; Ruan, Si-Min; Lin, Yuan; Liang, Jin-Yu; Shen, Shunli; Hu, Hang-Tong; Huang, Yang; Li, Wei; Wang, Zhu; Xie, Xian-Jin; Lü, Ming-De; Kuang, Ming; Wang, Wei

doi:10.1007/s00330-018-5927-8

Cited by 40 publications

(51 citation statements)

References 27 publications

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“…In our study, category LR-M showed a high sensitivity (91%) for non-HCC malignancy but a quite low PPV (36%) because of a high proportion of HCC (224 of 354 nodules [63%]) in LR-M. This is similar to prior reports (24)(25)(26) and suggests that further refinement of the LR-M category may be necessary (27). We looked further at the 354 LR-M nodules in our study and found that a group of 153 LR-M nodules with APHE and early onset mild (no punched-out appearance within 5 minutes) washout had an extremely high proportion of HCC (93%).…”

Section: Discussionsupporting

confidence: 88%

Evaluation of Contrast-enhanced US LI-RADS version 2017: Application on 2020 Liver Nodules in Patients with Hepatitis B Infection

Zheng

Zou

et al. 2020

Radiology

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Background: Use of contrast material-enhanced (CE) US Liver Imaging Reporting and Data System (LI-RADS) version 2017 has not been validated in large populations where hepatitis B virus (HBV) is endemic. Purpose: To evaluate the diagnostic performance of CE US LI-RADS version 2017 in a population with a high prevalence of HBV infection. Materials and Methods: In this retrospective study, liver nodules in patients with HBV who were evaluated from January 2004 to December 2016 were categorized as CE US LR-1 to LR-5 through LR-M. A subgroup of LR-M nodules was reclassified as LR-5, and additional analysis was performed. The reference standard consisted of histologic evaluation or composite imaging and clinical follow-up findings. Diagnostic performance was assessed with sensitivity, specificity, positive predictive value (PPV), and negative predictive value. Results: A total of 2020 nodules in 1826 patients (median age, 54 years 6 12 [standard deviation]; 1642 men) were included. Of the 1159 LR-5 lesions, 1141 were hepatocellular carcinoma (HCC); three, intrahepatic cholangiocarcinomas; six, other malignancies; six, atypical hyperplasia; and three, benign lesions. The PPV of LR-5 for HCC was 98% (95% confidence interval [CI]: 98%, 99%). In LR-M nodules, 153 showed arterial phase hyperenhancement, early washout, and absence of punched-out appearance within 5 minutes, and 142 of 153 (93%; 95% CI: 89%, 97%) were HCC. If these nodules were reclassified as LR-5, LR-M specificity and PPV as a predictor of non-HCC malignancy increased from 88% (95% CI: 87%, 89%) and 36% (95% CI: 31%, 41%) to 96% (95% CI: 95%, 97%) and 58% (95% CI: 51%, 65%), respectively (P , .001). Despite reclassification, LR-5 specificity and PPV remained high (94% [95% CI: 92%, 96%] and 98% [95% CI: 97%, 99%], respectively). Conclusion: The contrast-enhanced US Liver Imaging Reporting and Data System version 2017 category LR-5 is effectively predictive of the presence of hepatocellular carcinoma. In patients with hepatitis B virus infection, performance may be further improved by reclassification of category LR-M nodules with arterial phase hyperenhancement, early washout, and no punched-out appearance to LR-5. Published under a CC BY 4.0 license.

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Section: Discussionsupporting

confidence: 88%

Evaluation of Contrast-enhanced US LI-RADS version 2017: Application on 2020 Liver Nodules in Patients with Hepatitis B Infection

Zheng

Zou

et al. 2020

Radiology

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“…A total of 710 articles were identified in the database searches. After screening of the articles, eight articles that fulfilled the eligibility criteria were included in the meta-analysis [11][12][13][14][15][16][17][18].…”

Section: Search Resultsmentioning

confidence: 99%

Diagnostic Accuracy of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for Differentiating Between Hepatocellular Carcinoma and Other Hepatic Malignancies in High-Risk Patients: A Meta-Analysis

et al. 2020

Ultraschall Med

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Objectives The American College of Radiology (ACR) contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS), which includes diagnostic criteria for hepatocellular carcinoma (HCC) and other hepatic malignancies (OM), is increasingly used in clinical practice. This study performed a meta-analysis to assess the diagnostic accuracy of CEUS LI-RADS for differentiating between HCC and OM in high-risk patients. Methods PubMed, Embase (Ovid), and Cochrane (CENTRAL) were searched for relevant studies. All studies that reported the percentage of HCC and OM in the LI-RADS categories were included. Random-effects models were used to calculate the pooled sensitivity and specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curve. Results Eight studies involving 4215 focal liver lesions were included in the final analysis. The pooled sensitivity and specificity of the LR-5 criteria for HCC were 0.71 (95 % CI, 0.69–0.72) and 0.88 (0.85–0.91), respectively, the DOR was 18.36 (7.41–45.52), and the area under the SROC curve (AUC) was 0.8128. The pooled sensitivity and specificity of the LR-M criteria for OMs were 0.85 (0.81–0.88) and 0.86 (0.85–0.87), the DOR was 27.82 (11.83–65.40), respectively, and the SROC AUC was 0.9098. Conclusion The CEUS LI-RADS can effectively distinguish HCC from other hepatic malignancy in high-risk patients based on LR-5 criteria and LR-M criteria. However, further studies are needed for validation due to the limited number of included studies and the potential heterogeneity among the included studies.

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“…Several studies have confirmed that Liver Imaging Reporting and Data System of CEUS (CEUS LI-RADS) enables standardized diagnosis of HCC with substantial diagnostic efficiency [15,16]. One study reported good potential of CEUS LI-RADS with modified score system for diagnosing HCC and ICC [17]. Besides, one meta-analysis reported a high sensitivity and specificity for CEUS in HCC diagnosis, which were 0.85 (95%CI, 0.84-0.86) and 0.91 (95%CI, 0.90-0.92), respectively [18].…”

Section: Introductionmentioning

confidence: 96%

Contrast-enhanced ultrasound for the characterization of portal vein thrombosis vs tumor-in-vein in HCC patients: a systematic review and meta-analysis

et al. 2020

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Objectives Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. However, differentiation of thrombosis and tumor-in-vein (TIV) may be challenging. Contrast-enhanced ultrasound (CEUS) is an excellent method for detection of vascularization and could help in the distinction. We performed a systematic review and meta-analysis for evaluating the diagnostic value of CEUS in differentiating between PVT and TIV in hepatocellular carcinoma (HCC) patients. Methods PubMed, Embase, Cochrane Library, and Web of Science were searched up to the 5th of May 2019. The study quality was assessed by QUADAS-2 tool. Pooled sensitivity and specificity were calculated by the bivariate random effect model and hierarchical summary receiver-operating characteristic (SROC) curve was plotted. Results Seven studies including 425 participants were analyzed after screening 986 articles searched from databases. The pooled sensitivity and specificity of CEUS in diagnosing TIV were 0.94 (95%CI, 0.89-0.97) and 0.99 (95%CI, 0.80-1.00), respectively. The area under the curve (AUC) of SROC curve was 0.97 (95%CI, 0.95-0.98). The pooled sensitivity and AUC were consistent across all the subgroups of different subject numbers, country, study design, CEUS contrast agents, and diagnostic criteria. Conclusions CEUS is highly efficient in differentiating TIV from PVT and is an alternative or a substitute for CT and/or MRI. Trial registration PROSPERO registration number: CRD42019138847 Key Points • Characterization of portal vein thrombosis (PVT) vs tumor-in-vein (TIV) is critical for HCC staging. • CEUS has an excellent safety profile, provides a real-time analysis without any loss in accuracy compared with CT and MRI. • This meta-analysis demonstrates that contrast-enhanced ultrasound (CEUS) is a suitable method for the detection of PVT and distinction with TIV.

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Comparison between M-score and LR-M in the reporting system of contrast-enhanced ultrasound LI-RADS

Cited by 40 publications

References 27 publications

Evaluation of Contrast-enhanced US LI-RADS version 2017: Application on 2020 Liver Nodules in Patients with Hepatitis B Infection

Evaluation of Contrast-enhanced US LI-RADS version 2017: Application on 2020 Liver Nodules in Patients with Hepatitis B Infection

Diagnostic Accuracy of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for Differentiating Between Hepatocellular Carcinoma and Other Hepatic Malignancies in High-Risk Patients: A Meta-Analysis

Contrast-enhanced ultrasound for the characterization of portal vein thrombosis vs tumor-in-vein in HCC patients: a systematic review and meta-analysis

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