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

Sevim, Sezgin; Dıcle, Oğuz; Gezer, Naciye Sinem; Barış, Mustafa; Altay, Canan; Akin, İşıl Başara

doi:10.5114/pjr.2019.90090

Cited by 7 publications

(13 citation statements)

References 22 publications

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“…23 Prior studies show the reproducibility of LR-3-LR-4 lesions were lower than other categories. 25,26 This study showed the reproducibility level of LR-3-LR-4 remained relatively low even after training. It is indeed unfortunate, considering that the surveillance of these intermediate lesions is more important in cirrhotic patients.…”

Section: Discussionmentioning

confidence: 79%

“…Most were single-center studies with 2-10 readers, except for one multicenter study with 113 readers and one dual-center study with 3 readers. [19][20][21][22][23][24][25][26][27][28][29][30] These studies obtained variable reproducibility, ranging from slight compliance to fair compliance for the intermediate categories (LR-2-LR-4), from moderate to perfect for other categories, and from poor to perfect for the overall category. All the studies mentioned above refer to LI-RADS versions 2013-2017, except one that refers to version 2018.…”

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confidence: 99%

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Does Training in LI‐RADS Version 2018 Improve Readers' Agreement with the Expert Consensus and Inter‐reader Agreement in MRI Interpretation?

Zhang

Ren

et al. 2021

Magnetic Resonance Imaging

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Background: The Liver Imaging Reporting and Data System (LI-RADS) was established for noninvasive diagnosis for hepatocellular carcinoma (HCC). However, whether training can improve readers' agreement with the expert consensus and inter-reader agreement for final categories is still unclear. Purpose: To explore training effectiveness on readers' agreement with the expert consensus and inter-reader agreement. Study Type: Prospective. Subjects: Seventy lesions in 61 patients at risk of HCC undergoing liver MRI; 20 visiting scholars. Field Strength/Sequence: 1.5 T or 3 T, Dual-echo T 1 WI, Fast spin-echo T 2 WI, SE-EPI DWI, and Dynamic multiphase fast gradient-echo T 1 WI. Assessment: Seventy lesions assigned LI-RADS categories of LR1-LR5, LR-M, and LR-TIV by three radiologists in consensus were randomly selected, with 10 cases for each category. The consensus opinion was the standard reference. The third radiologist delivered the training. Twenty readers reviewed images independently and assigned each an LI-RADS category both before and after the training.

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Section: Discussionmentioning

confidence: 79%

mentioning

confidence: 99%

Does Training in LI‐RADS Version 2018 Improve Readers' Agreement with the Expert Consensus and Inter‐reader Agreement in MRI Interpretation?

Zhang

Ren

et al. 2021

Magnetic Resonance Imaging

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“…4 , 5 Accordingly, there has been increasing reliance upon imaging and radiologists for both early and accurate diagnosis of HCC, using a universal reporting language. 6 …”

Section: Introductionmentioning

confidence: 99%

“…However, some literature has questioned the accuracy and reliability of the LI-RADS risk stratification. 6 , 7 Furthermore, the updated LI-RADS version 2018 has not been widely validated. 8 , 9 , 10 , 11 This retrospective study aims to evaluate the diagnostic accuracy and inter-reader reliability of the current LI-RADS version 2018 lexicon amongst board certified fellowship trained body imaging radiologists as compared with an expert consensus reference standard.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy and inter-reader reliability of the MRI Liver Imaging Reporting and Data System (version 2018) risk stratification and management system

Singh

Wilson

Manolea

et al. 2022

South African Journal of Radiology

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Background: Hepatocellular carcinoma (HCC) can be diagnosed non-invasively, provided certain imaging criteria are met. However, the recent Liver Imaging Reporting and Data System (LI-RADS) version 2018 has not been widely validated.Objectives: This study aimed to evaluate the diagnostic accuracy and reader reliability of the LI-RADS version 2018 lexicon amongst fellowship trained radiologists compared with an expert consensus reference standard.Method: This retrospective study was conducted between 2018 and 2020. A total of 50 contrast enhanced liver magnetic resonance imaging (MRI) studies evaluating focal liver observations in patients with cirrhosis, hepatitis B virus (HBV) or prior HCC were acquired. The standard of reference was a consensus review by three fellowship-trained radiologists. Diagnostic accuracy including sensitivity, specificity, positive predictive value (PPV), negative predictive values (NPV) and area under the curve (AUC) values were calculated per LI-RADS category for each reader. Kappa statistics were used to measure reader agreement.Results: Readers demonstrated excellent specificities (88% – 100%) and NPVs (85% – 100%) across all LI-RADS categories. Sensitivities were variable, ranging from 67% to 83% for LI-RADS 1, 29% to 43% for LI-RADS 2, 100% for LI-RADS 3, 70% to 80% for LI-RADS 4 and 80% to 84% for LI-RADS 5. Readers showed excellent accuracy for differentiating benign and malignant liver lesions with AUC values 0.90. Overall inter-reader agreement was ‘good’ (kappa = 0.76, p 0.001). Pairwise inter-reader agreement was ‘very good’ (kappa ≥ 0.90, p 0.001).Conclusion: The LI-RADS version 2018 demonstrates excellent specificity, NPV and AUC values for risk stratification of liver observations by radiologists. Liver Imaging Reporting and Data System can reliably differentiate benign from malignant lesions when used in conjunction with corresponding LI-RADS management recommendations.

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“…The LI-RADS is a reporting system that is designed to improve and reduces variability and difficulties in the elucidation of imaging findings leading to the most accurate diagnosis, proper staging, and hence, proper treatment [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Optimizing diagnostic imaging data using LI-RADS and the Likert scale in patients with hepatocellular carcinoma

et al. 2021

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IntroductionThe study aimed to compare the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS), which incorporates fixed criteria, and the Likert scale (LS), which mainly depends on an overall impression in liver lesion diagnosis.Material and methodsDiagnostic data of 110 hepatic nodules in 103 high-risk patients for hepatocellular carcinoma (HCC) were included. Data including diameter, arterial hyperenhancement, washout, and capsule were reviewed by 2 readers using LI-RADS and LS (range, score 1-5). Inter-reader agreement (IRA), intraclass agreement (ICA), and diagnostic performance were determined by Fleiss, Cohen’s , and logistic regression, respectively.ResultsThere were 53 triphasic enhanced computed tomography (CT) and 50 dynamic magnetic resonance (MR) examinations. Overall, IRA was excellent ( = 0.898). IRA was good for arterial hyperenhancement ( = 0.705), washout ( = 0.763), and capsule ( = 0.771) and excellent for diameter ( = 0.981) and tumour embolus ( = 0.927). Overall, ICA between LI-RADS and LS was fair 0.32; ICA was good for scores of 1 ( = 0.682), fair for scores of 2 ( = 0.36), moderate for scores of 5 ( = 0.52), but no agreement was found for scores of 3 ( = –0.059) and 4 ( = –0.022). LIRADS produced relatively high accuracy (87.3% vs. 80%), relatively low sensitivity (84.3% vs. 98%), and significantly higher specificity (89.83% vs. 64.4%) and positive likelihood ratio (+LR: 8.29 vs. 2.75) compared to LS approach.ConclusionsLI-RADS revealed higher diagnostic accuracy as compared to LS with statistical proof higher specificity and +LR showing its ability to foretell malignancy in high-risk patients. We recommend the practical application of the LI-RADS system in the detection and treatment response monitoring of patients with HCC.

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

Abstract: Purpose: To investigate the reproducibility of LIRADS v2014 and contribute to its widespread use in clinical practice.

Cited by 7 publications

References 22 publications

Does Training in LI‐RADS Version 2018 Improve Readers' Agreement with the Expert Consensus and Inter‐reader Agreement in MRI Interpretation?

Does Training in LI‐RADS Version 2018 Improve Readers' Agreement with the Expert Consensus and Inter‐reader Agreement in MRI Interpretation?

Diagnostic accuracy and inter-reader reliability of the MRI Liver Imaging Reporting and Data System (version 2018) risk stratification and management system

Optimizing diagnostic imaging data using LI-RADS and the Likert scale in patients with hepatocellular carcinoma

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