Reliability, Validity, and Reader Acceptance of LI-RADS—An In-depth Analysis

Barth, Borna K.; Donati, Olivio F.; Fischer, Michael A.; Ulbrich, Erika J.; Karlo, Christoph; Becker, Anton S.; Seifert, Burkhard; Reiner, Caecilia S.

doi:10.1016/j.acra.2016.03.014

Cited by 40 publications

(30 citation statements)

References 21 publications

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“…In our study, we found a medium level of reproducibility (κ = 0.414-0.600) for the major parameters of the LIRADS reporting system. These were in accord with the results of similar research [13,19].…”

Section: Discussionsupporting

confidence: 93%

How high is the inter-observer reproducibility in the LIRADS reporting system?

et al. 2019

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Section: Discussionsupporting

confidence: 93%

How high is the inter-observer reproducibility in the LIRADS reporting system?

et al. 2019

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“…For the major features, our agreement levels (maximum diameter, 0.93; arterial phase hyperenhancement [any type], 0.53; washout [any type], 0.48; capsule appearance, 0.54) are also comparable with previously published values (maximum diameter, 0.89-0.97; arterial phase hyperenhancement, 0.51-0.72; washout, 0.45-0.54; capsule appearance, 0.36-0.63) (26)(27)(28).…”

Section: Gastrointestinal Imaging: Diagnostic Performance Of Li-rads supporting

confidence: 90%

“…When we considered all LI-RADS categories (for all benign and malignant lesions), agreement was moderate (k = 0.55; 95% CI: 0.47, 0.63) and compared favorably with that reported in previous publications (k = 0.43-0.45) (26)(27)(28). For the purposes of transplant listing, liver mass categorization is essentially binary (ie, LR-5 vs not LR-5), as the LR-5 category alone grants eligibility for Organ Procurement and Transplantation Network exception points (provided the Milan criteria are also satisfied).…”

Section: Gastrointestinal Imaging: Diagnostic Performance Of Li-rads supporting

confidence: 57%

Differentiation of Hepatocellular Carcinoma from Other Hepatic Malignancies in Patients at Risk: Diagnostic Performance of the Liver Imaging Reporting and Data System Version 2014

et al. 2018

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Purpose To evaluate the diagnostic performance and interrater reliability of the Liver Imaging Reporting and Data System (LI-RADS) version 2014 in differentiating hepatocellular carcinoma (HCC) from non-HCC malignancy in a population of patients at risk for HCC. Materials and Methods This retrospective HIPAA-compliant institutional review board-approved study was exempt from informed consent. A total of 178 pathology-proven malignant liver masses were identified in 178 patients at risk for HCC but without established extrahepatic malignancy from August 2012 through August 2015. Two readers blinded to pathology findings and clinical follow-up data independently evaluated a liver protocol magnetic resonance or computed tomography study for each lesion and assigned LI-RADS categories, scoring all major and most ancillary features. Statistical analyses included the independent samples t test, x test, Fisher exact test, and Cohen k. Results This study included 136 HCCs and 42 non-HCC malignancies. Specificity and positive predictive value of an HCC imaging diagnosis (LR-5 or LR-5V) were 69.0% and 90.5%, respectively, for reader 1 (R1) and 88.3% and 95.5%, respectively, for reader 2 (R2). Tumor in vein was a common finding in patients with non-HCC malignancies (R1, 10 of 42 [23.8%]; R2, five of 42 [11.9%]). Exclusion of the LR-5V pathway improved specificity and positive predictive value for HCC to 83.3% and 92.9%, respectively, for R1 (six fewer false-positive findings) and 92.3% and 96.4%, respectively, for R2 (one fewer false-positive finding). Among masses with arterial phase hyperenhancement, the rim pattern was more common among non-HCC malignancies than among HCCs for both readers (R1: 24 of 36 [66.7%] vs 13 of 124, [10.5%], P < .001; R2: 27 of 35 [77.1%] vs 21 of 123 [17.1%], P < .001) (k = 0.76). Exclusion of rim arterial phase hyperenhancement as a means of satisfying LR-5 criteria also improved specificity and positive predictive value for HCC (R1, two fewer false-positive findings). Conclusion Modification of the algorithmic role of tumor in vein and rim arterial phase hyperenhancement improves the diagnostic performance of LI-RADS version 2014 in differentiating HCC from non-HCC malignancy. RSNA, 2017 Online supplemental material is available for this article.

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“…Six prior studies have assessed reader agreement regarding LI-RADS categories (11,19,20) or major features of HCC (11,(19)(20)(21)(22). Unlike these studies, which all included readers from the same institution, ours is further enhanced by (a) multicenter international cross-sectional reader pool, including community practice, academic, and mixed practice environments; (b) derivation of the cases from eight different sites; (c) the largest number of readers tested to date; (d) no training module aside from the LI-RADS materials available online; (e) mixture of all LI-RADS 10% of total cases.…”

Section: Agreement On Major Featuresmentioning

confidence: 99%

Interreader Reliability of LI-RADS Version 2014 Algorithm and Imaging Features for Diagnosis of Hepatocellular Carcinoma: A Large International Multireader Study

Fowler¹,

Tang²,

Santillan³

et al. 2018

Radiology

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Supported by a research scholarship from the Fonds de Recherche du Québec-Santé and Fondation de l'association des radiologistes du Québec (FRQS-ARQ #26993).q RSNA, 2017 Purpose:To determine in a large multicenter multireader setting the interreader reliability of Liver Imaging Reporting and Data System (LI-RADS) version 2014 categories, the major imaging features seen with computed tomography (CT) and magnetic resonance (MR) imaging, and the potential effect of reader demographics on agreement with a preselected nonconsecutive image set. Materials and Methods:Institutional review board approval was obtained, and patient consent was waived for this retrospective study. Ten image sets, comprising 38-40 unique studies (equal number of CT and MR imaging studies, uniformly distributed LI-RADS categories), were randomly allocated to readers. Images were acquired in unenhanced and standard contrast material-enhanced phases, with observation diameter and growth data provided. Readers completed a demographic survey, assigned LI-RADS version 2014 categories, and assessed major features. Intraclass correlation coefficient (ICC) assessed with mixed-model regression analyses was the metric for interreader reliability of assigning categories and major features. Results: Conclusion:ICC is good for final LI-RADS categorization and high for major feature characterization, with minimal reader demographic effect. Of note, our results using selected image sets from nonconsecutive examinations are not necessarily comparable with those of prior studies that used consecutive examination series.q RSNA, 2017

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Reliability, Validity, and Reader Acceptance of LI-RADS—An In-depth Analysis

Cited by 40 publications

References 21 publications

How high is the inter-observer reproducibility in the LIRADS reporting system?

How high is the inter-observer reproducibility in the LIRADS reporting system?

Differentiation of Hepatocellular Carcinoma from Other Hepatic Malignancies in Patients at Risk: Diagnostic Performance of the Liver Imaging Reporting and Data System Version 2014

Interreader Reliability of LI-RADS Version 2014 Algorithm and Imaging Features for Diagnosis of Hepatocellular Carcinoma: A Large International Multireader Study

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