Diagnostic Value of CEUS LI-RADS Version 2017 in Differentiating AFP-Negative Hepatocellular Carcinoma from Other Primary Malignancies of the Liver

Abstract

Purpose: To explore the diagnostic value of Contrast-enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 (CEUS LI-RADS v2017) in differentiating alpha-fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) from other primary malignancies (OM) of the liver. Methods: The data of 99 patients with primary liver malignant tumors confirmed by surgical pathology and AFP-negative from January 2018 to January 2021 were retrospectively analyzed, and the lesions were divided into 61 cases in the AFP-negative HCC group and 38 cases in the OM group according to the pathological findings, the CEUS features of the lesions were analyzed and the lesions were classified according to the CEUS LI-RADS v2017. Comparison of CEUS features between the two groups was performed using the χ2 test. The sensitivity, specificity, positive predictive value, negative predictive value, and coincidence rate of CEUS LI-RADS v2017 for the diagnosis of AFP-negative HCC and OM were calculated using pathological findings as the gold standard. Results: The differences in features of arterial phase enhancement and wash-out between the HCC and OM groups were statistically significant (p < 0.05). The sensitivity of diagnosing HCC by LR-5 was 62.3% and the specificity was 92.1%. The sensitivity of diagnosing OM by LR-M was 92.1% and the specificity was 83.6%. Conclusions: When AFP is negative in patients with intrahepatic focal lesions, LR-5 has high specificity but low sensitivity in the diagnosis of HCC, and LR-M has high sensitivity and specificity in the diagnosis of OM. CEUS LI-RADS is a tool to differentiate AFP-negative HCC and OM effectively.

LI-RADS LR-5 on contrast-enhanced ultrasonography has satisfactory diagnostic specificity for hepatocellular carcinoma: a systematic review and meta-analysis

“…Therefore, due to the specific principles of LI-RADS of CEUS and CT/MRI, CEUS might supplement the clinical value than CT/MRI, displaying a lower missed diagnosis rate and a lower false positive rate (32). Furthermore, according to the still and pre-set imaging techniques in a previous study, CT/MRI was not able to observe the existence of hyperenhancement in both the early and late arterial phase, which was possible in the CEUS examination (33). Consequently, the CEUS LI-RADS might increase diagnostic accuracy by providing more detailed and specific judging criteria than the CT/MRI LI-RADS.…”

Elevated expression patterns of P-element Induced Wimpy Testis (PIWI) transcripts are potential candidate markers for Hepatocellular Carcinoma

“…There is a widely accepted protocol for diagnosing chronic liver disorders (CLD), which involves evaluating liver function using a series of serum-level enzyme assays and a significant tumour marker, -fetoprotein (AFP); and imaging techniques such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), which have advanced dramatically in recent years. However, AFP has exhibited suboptimal results in terms of therapeutic surveillance and early identification [ 6 ]. Subsequently There is a need for more accurate serum biomarkers with increased sensitivity and specificity that complement AFP and improve clinical outcomes for patients.…”

P- element Induced Wimpy Testis (PIWI), a Potential Candidate Marker for Hepatocellular Carcinoma

“…The sensitivity and speci city of AFP in the early phases of hepatocarcinogenesis vary according to numerous investigations. However, AFP has exhibited suboptimal results in terms of therapeutic surveillance and early identi cation 8 . As a result, much effort has been made to develop a reliable molecular marker for HCC in its early stages 9 .…”