LI-RADS treatment response categorization on gadoxetic acid-enhanced MRI: diagnostic performance compared to mRECIST and added value of ancillary features

Interreader Reliability of Liver Imaging Reporting and Data System Treatment Response: A Systematic Review and Meta-Analysis

“…The systematic search identified 156 studies, and 104 were screened after removal of 52 duplicates (Figure 1). After the exclusion of 90 studies by screening of the title and abstract, and six studies by full-text reviews, eight studies were finally included in this systematic review and meta-analysis [10][11][12][13][14][15][16][17]. Because one study [14] investigating the interreader reliability of both CT and MRI had a population overlapping with that of another MRI study [13], the CT interreader reliability result was separately included from this study.…”

“…The characteristics of the eligible studies are described in Table 1. One [10] collected the patients prospectively whereas the others [11][12][13][14][15][16][17] were retrospective studies. Hepatitis B was the most common underlying liver disease in four studies, which were all from Eastern countries [13][14][15]17].…”

“…One [10] collected the patients prospectively whereas the others [11][12][13][14][15][16][17] were retrospective studies. Hepatitis B was the most common underlying liver disease in four studies, which were all from Eastern countries [13][14][15]17]. The population was dominated by patients with hepatitis C and alcoholic hepatitis in three studies from Western countries [11,12,16], while one study did not provide information on underlying liver disease [10].…”

“…The population was dominated by patients with hepatitis C and alcoholic hepatitis in three studies from Western countries [11,12,16], while one study did not provide information on underlying liver disease [10]. The locoregional treatment was local ablation only (e.g., radiofrequency ablation, microwave ablation, and percutaneous ethanol ablation) in three studies [11,12,17], transarterial treatment (e.g., conventional transarterial chemoembolization, drug-eluting beads transarterial chemoembolization, and transarterial radioembolization) only in one study [16], and both local ablation and transarterial treatment in four studies [10,[13][14][15]. Image analysis was independently performed by two readers in six studies [10,[12][13][14][15]17] and by three readers in two studies [11,16].…”

“…Notwithstanding the importance of the diagnostic performance, it is essential that the LR-TR has high interreader reliability if it is to be used for determining treatment response and deciding on a proper management strategy in patients with HCC. Prior studies have reported on the interreader reliability of the LR-TR [10][11][12][13][14][15][16][17], but their results are subject to limitations because of their relatively small sample sizes and between-study variability in the reported data. Given the increased attention to LR-TR in clinical practice, we consider it timely and important to determine the interreader reliability of LR-TR and to understand any differences among the published studies.…”