Contrast-enhanced ultrasound Liver Imaging Reporting and Data System: Lights and shadows in hepatocellular carcinoma and cholangiocellular carcinoma diagnosis

Vidili, Gianpaolo; Arru, Marco; Solinas, Giuliana; Calvisi, Diego F.; Meloni, Pierluigi; Sauchella, Assunta; Turilli, Davide; Fabio, Claudio; Cossu, Antonio; Madeddu, Giordano; Babudieri, Sergio; Zocco, Maria Assunta; Iannetti, Gian Domenico; Lembo, Enza Di; Delitala, Alessandro; Manetti, Roberto

doi:10.3748/wjg.v28.i27.3488

Cited by 15 publications

(9 citation statements)

References 52 publications

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“…Although LI-RADS is not just a diagnostic tool, its diagnostic performance has always been concerned, especially that of LR-5 for HCC. In this study, CEUS LR-5 showed high PPV and specificity for HCC ≤ 2 cm, which was consistent with the purpose of LI-RADS and similar to results of previous study (16)(17)(18)(19). In our study, EOB-MRI LR-5 also showed high PPV and specificity for HCC ≤ 2 cm, similar to previous studies (20,21).…”

Section: Discussionsupporting

confidence: 92%

The comparison of contrast-enhanced ultrasound and gadoxetate disodium-enhanced MRI LI-RADS for nodules ≤2 cm in patients at high risk for HCC: a prospective study

Qin,

Zhou,

Zhang

et al. 2024

Front. Oncol.

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ObjectivesTo investigate the consistency of LI-RADS of CEUS and EOB-MRI in the categorization of liver nodules ≤2cm in patients at high risk for HCC.MethodsPatients at high risk for HCC with nodules ≤2cm who underwent CEUS and EOB-MRI in our hospital were prospectively enrolled. The CEUS images and EOB-MRI imaging of each liver nodule were observed to evaluate inter-observer consistency and category according to CEUS LI-RADS V2017 and CT/MRI LI-RADS V2017 criteria double blinded. Pathology and/or follow-up were used as reference standard.ResultsA total of 127 nodules in 119 patients met the inclusion criteria. The inter-observer agreement was good on CEUS and EOB-MRI LI-RADS (kappa = 0.76, 0.76 p < 0.001). The inter-modality agreement was fair (kappa=0.21, p < 0.001). There was no statistical difference in PPV and specificity between CEUS and EOB-MRI LR-5 for HCC, while the difference in AUC was statistically significant. We used new criteria (CEUS LR-5 and EOB-MRI LR-4/5 or CEUS LR-4/5 and EOB-MRI LR-5) to diagnose HCC. The sensitivity, specificity, and AUC of this criteria was 63.4%, 95.6%, and 0.80.ConclusionsCEUS and EOB-MRI showed fair inter-modality agreement in LI-RADS categorization of nodules ≤2 cm. The inter-observer agreement of CEUS and EOB-MRI LI-RADS were substantial. CEUS and EOB-MRI LR-5 have equally good positive predictive value and specificity for HCC ≤ 2cm, and combining these two modalities may better diagnose HCC ≤ 2 cm.Clinical Trial Registrationhttps://clinicaltrials.gov/, identifier NCT04212286.

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Section: Discussionsupporting

confidence: 92%

The comparison of contrast-enhanced ultrasound and gadoxetate disodium-enhanced MRI LI-RADS for nodules ≤2 cm in patients at high risk for HCC: a prospective study

Qin,

Zhou,

Zhang

et al. 2024

Front. Oncol.

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“…Three studies were prospective ( 13 , 19 , 38 ) and 23 were retrospective ( 14 - 18 , 20 - 37 ). Of the studies, 10 used histopathology only as the reference standard ( 15 , 16 , 19 , 21 , 23 - 25 , 27 , 30 , 33 ) and 16 used both histopathology and imaging follow-up as the reference standard ( 13 , 14 , 17 , 18 , 20 , 22 , 26 , 28 , 29 , 31 , 32 , 34 - 38 ).…”

Section: Resultsmentioning

confidence: 99%

Compared with SonoVue® LR-5, Sonazoid® modified LR-5 has better diagnostic sensitivity for hepatocellular carcinoma: a systematic review and meta-analysis

Cao,

Wang,

Ling

2024

Quant Imaging Med Surg

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Background The contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) is a standardized system for reporting liver nodules in patients at risk of developing hepatocellular carcinoma (HCC) and is only recommended for pure blood pool agents such as SonoVue ® . A modified LI-RADS was proposed for Sonazoid ® , a Kupffer cell-specific contrast agent. This meta-analysis was conducted to compare the diagnostic efficiency of the CEUS LI-RADS for SonoVue ® and the modified LI-RADS for Sonazoid ® . Methods The PubMed, Medline, Web of Science, Embase, and Cochrane Library databases were systematically searched to retrieve studies on the diagnostic efficiency of the CEUS LI-RADS algorithms in diagnosing HCC using SonoVue ® and/or Sonazoid ® from January 2016 to June 2023. Histopathology or imaging follow-up served as the reference standards. Only articles published in English on retrospective or prospective studies with full reports were included in the meta-analysis. A bivariate random-effects model was used. Data pooling, meta-regression, and sensitivity analysis were performed for the meta-analysis. Deeks’ funnel plot asymmetry test was used to evaluate publication bias, and the QUADAS-2 tool was used to assess the methodological quality of eligible studies. Results In total, 26 studies comprising 8,495 patients with 9,244 lesions were included in the meta-analysis. The pooled data results for SonoVue ® LI-RADS category 5 (LR-5) and Sonazoid ® modified LR-5 were as follows: pooled sensitivity: 0.68 [95% confidence interval (CI): 0.64–0.73, I 2 =89.20%; P<0.01] and 0.82 (95% CI: 0.74–0.87, I 2 =85.39%; P<0.01) (P<0.05); pooled specificity: 0.93 (95% CI: 0.90–0.96, I 2 =86.52%; P<0.01) and 0.86 (95% CI: 0.79–0.91, I 2 =59.91%; P=0.01) (P<0.05); pooled area under the curve (AUC): 0.86 (95% CI: 0.82–0.89) and 0.91 (95% CI: 0.88–0.93) (P<0.05), respectively. The meta-regression analysis revealed that the study design, subject enrollment method, and reference standard contributed to the heterogeneity of SonoVue ® LR-5, and the number of lesions was a source of heterogeneity for Sonazoid ® modified LR-5. The diagnostic performance of the LI-RADS category M (LR-M) algorithms of SonoVue ® and Sonazoid ® was comparable. Conclusions The Sonazoid ® modified LR-5 algorithm had a higher diagnostic sensitivity, lower specificity, and higher AUC than SonoVue ® LR-5.

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“…During CEUS assessment, ICC could show hyperenhancement during the arterial phase ( Figure 3 ) with washout. According to several authors, ICC washout at its earliest stage is comparable to HCC, and this finding should guide a correct diagnosis [ 82 , 83 , 84 ].…”

Section: Resultsmentioning

confidence: 99%

Update on the Applications of Radiomics in Diagnosis, Staging, and Recurrence of Intrahepatic Cholangiocarcinoma

et al. 2023

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Background: This paper offers an assessment of radiomics tools in the evaluation of intrahepatic cholangiocarcinoma. Methods: The PubMed database was searched for papers published in the English language no earlier than October 2022. Results: We found 236 studies, and 37 satisfied our research criteria. Several studies addressed multidisciplinary topics, especially diagnosis, prognosis, response to therapy, and prediction of staging (TNM) or pathomorphological patterns. In this review, we have covered diagnostic tools developed through machine learning, deep learning, and neural network for the recurrence and prediction of biological characteristics. The majority of the studies were retrospective. Conclusions: It is possible to conclude that many performing models have been developed to make differential diagnosis easier for radiologists to predict recurrence and genomic patterns. However, all the studies were retrospective, lacking further external validation in prospective and multicentric cohorts. Furthermore, the radiomics models and the expression of results should be standardized and automatized to be applicable in clinical practice.

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Contrast-enhanced ultrasound Liver Imaging Reporting and Data System: Lights and shadows in hepatocellular carcinoma and cholangiocellular carcinoma diagnosis

Cited by 15 publications

References 52 publications

The comparison of contrast-enhanced ultrasound and gadoxetate disodium-enhanced MRI LI-RADS for nodules ≤2 cm in patients at high risk for HCC: a prospective study

The comparison of contrast-enhanced ultrasound and gadoxetate disodium-enhanced MRI LI-RADS for nodules ≤2 cm in patients at high risk for HCC: a prospective study

Compared with SonoVue® LR-5, Sonazoid® modified LR-5 has better diagnostic sensitivity for hepatocellular carcinoma: a systematic review and meta-analysis

Update on the Applications of Radiomics in Diagnosis, Staging, and Recurrence of Intrahepatic Cholangiocarcinoma

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