Does quantitative assessment of arterial phase hyperenhancement and washout improve LI-RADS v2018–based classification of liver lesions?

Stocker, Daniel; Becker, Anton S.; Barth, Borna K.; Skawran, Stephan; Kaniewska, Malwina; Fischer, Michael A.; Donati, Olivio F.; Reiner, Caecilia S.

doi:10.1007/s00330-019-06596-9

Cited by 18 publications

(12 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, washout is a purely visual criterion, which may result in observer-dependent bias. According to the literature reports, quantitative washout assessment in LI-RADS has the opposite effect in HCC diagnosis and needs to be redefined (40).…”

Section: Discussionmentioning

confidence: 99%

A Computed Tomography Nomogram for Assessing the Malignancy Risk of Focal Liver Lesions in Patients With Cirrhosis: A Preliminary Study

Wang

Liang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

PurposeThe detection and characterization of focal liver lesions (FLLs) in patients with cirrhosis is challenging. Accurate information about FLLs is key to their management, which can range from conservative methods to surgical excision. We sought to develop a nomogram that incorporates clinical risk factors, blood indicators, and enhanced computed tomography (CT) imaging findings to predict the nature of FLLs in cirrhotic livers.MethodA total of 348 surgically confirmed FLLs were included. CT findings and clinical data were assessed. All factors with P < 0.05 in univariate analysis were included in multivariate analysis. ROC analysis was performed, and a nomogram was constructed based on the multivariate logistic regression analysis results.ResultsThe FLLs were either benign (n = 79) or malignant (n = 269). Logistic regression evaluated independent factors that positively affected malignancy. AFP (OR = 10.547), arterial phase hyperenhancement (APHE) (OR = 740.876), washout (OR = 0.028), satellite lesions (OR = 15.164), ascites (OR = 156.241), and nodule-in-nodule architecture (OR =27.401) were independent predictors of malignancy. The combined predictors had excellent performance in differentiating benign and malignant lesions, with an AUC of 0.959, a sensitivity of 95.24%, and a specificity of 87.5% in the training cohort and AUC of 0.981, sensitivity of 94.74%, and specificity of 93.33% in the test cohort. The C-index was 96.80%, and calibration curves showed good agreement between the nomogram predictions and the actual data.ConclusionsThe nomogram showed excellent discrimination and calibration for malignancy risk prediction, and it may aid in making FLLs treatment decisions.

show abstract

Section: Discussionmentioning

confidence: 99%

A Computed Tomography Nomogram for Assessing the Malignancy Risk of Focal Liver Lesions in Patients With Cirrhosis: A Preliminary Study

Wang

Liang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…To represent the degree of APHE, our model calculates the percentage of arterial enhancement (PAE) [ 17 ] for the corresponding voxels as follows:

…”

Section: Materials and Methodsmentioning

confidence: 99%

“…To describe the degree of WO, we improved the lesion-to-liver contrast ratio (LLCR), which is similar to that in [ 17 ] but slightly more complicated. We needed to ensure that the voxel is in

.…”

Section: Materials and Methodsmentioning

confidence: 99%

“…One of the solutions to overcome the weakness of LI-RADS is to investigate the quantitative estimation of major imaging features. To date, several research studies have focused on quantitative assessment of HCC features in contrast-enhanced liver CT [ 13 , 14 ] and MRI [ 15 , 16 , 17 ]. For the APHE, Kim et al.…”

Section: Introductionmentioning

confidence: 99%

“…Stocker et al. [ 17 ] compared the qualitative and quantitative results of APHE and WO appearance defined by LI-RADS v2018 in MRI; they reported that for WO quantitative assessment required further improvement to match the diagnostic accuracy of qualitative LI-RADS v2018. However, these WO-focused studies were performed in 2D ROIs selected by the radiologist to describe the imaging feature between the lesion and liver parenchyma.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Three-Dimensional Voxel-Wise Quantitative Assessment of Imaging Features in Hepatocellular Carcinoma

et al. 2023

View full text Add to dashboard Cite

Voxel-wise quantitative assessment of typical characteristics in three-dimensional (3D) multiphase computed tomography (CT) imaging, especially arterial phase hyperenhancement (APHE) and subsequent washout (WO), is crucial for the diagnosis and therapy of hepatocellular carcinoma (HCC). However, this process is still missing in practice. Radiologists often visually estimate these features, which limit the diagnostic accuracy due to subjective interpretation and qualitative assessment. Quantitative assessment is one of the solutions to this problem. However, performing voxel-wise assessment in 3D is difficult due to the misalignments between images caused by respiratory and other physiological motions. In this paper, based on the Liver Imaging Reporting and Data System (v2018), we propose a registration-based quantitative model for the 3D voxel-wise assessment of image characteristics through multiple CT imaging phases. Specifically, we selected three phases from sequential CT imaging phases, i.e., pre-contrast phase (Pre), arterial phase (AP), delayed phase (DP), and then registered Pre and DP images to the AP image to extract and assess the major imaging characteristics. An iterative reweighted local cross-correlation was applied in the proposed registration model to construct the fidelity term for comparison of intensity features across different imaging phases, which is challenging due to their distinct intensity appearance. Experiments on clinical dataset showed that the means of dice similarity coefficient of liver were 98.6% and 98.1%, those of surface distance were 0.38 and 0.54 mm, and those of Hausdorff distance were 4.34 and 6.16 mm, indicating that quantitative estimation can be accomplished with high accuracy. For the classification of APHE, the result obtained by our method was consistent with those acquired by experts. For the WO, the effectiveness of the model was verified in terms of WO volume ratio.

show abstract

Editorial for “Interreader Agreement of Liver Imaging Reporting and Data System on MRI: A Systematic Review and Meta Analysis”

Chernyak

Sirlin

2020

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

Does quantitative assessment of arterial phase hyperenhancement and washout improve LI-RADS v2018–based classification of liver lesions?

Cited by 18 publications

References 34 publications

A Computed Tomography Nomogram for Assessing the Malignancy Risk of Focal Liver Lesions in Patients With Cirrhosis: A Preliminary Study

A Computed Tomography Nomogram for Assessing the Malignancy Risk of Focal Liver Lesions in Patients With Cirrhosis: A Preliminary Study

Three-Dimensional Voxel-Wise Quantitative Assessment of Imaging Features in Hepatocellular Carcinoma

Editorial for “Interreader Agreement of Liver Imaging Reporting and Data System on MRI: A Systematic Review and Meta Analysis”

Contact Info

Product

Resources

About