Imaging Outcomes of Liver Imaging Reporting and Data System Version 2014 Category 2, 3, and 4 Observations Detected at CT and MR Imaging

Tanabe, Masahiro; Kanki, Akihiko; Wolfson, Tanya; Costa, Eduardo; Mamidipalli, Adrija; Ferreira, Marilia P. F. D.; Santillan, Cynthia; Middleton, Michael S.; Gamst, Anthony; Kono, Yuko; Kuo, Alexander; Sirlin, Claude B.

doi:10.1148/radiol.2016152173

Cited by 88 publications

(74 citation statements)

References 19 publications

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“…Similarly, Ren et al demonstrated higher accuracy of LR‐5 using v2018 than v2017 (84% versus 78%, respectively) . This potentially will allow earlier and more efficacious intervention, albeit at the cost of more false‐positive diagnoses . In our study, 1 high‐grade dysplastic nodule met the criteria for LR‐5 based on v2018 and not based on v2017, decreasing the point estimate for the PPV of the LR‐5 category from 100% to 96.4% in the subset of observations with available histology.…”

Section: Discussionsupporting

confidence: 53%

Liver Imaging Reporting and Data System Version 2018: Impact on Categorization and Hepatocellular Carcinoma Staging

et al. 2019

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The purpose of this study was to assess the concordance in categorization and radiologic T staging using Liver Imaging Reporting and Data System (LI‐RADS, LR) version 2017 (v2017), version 2018 (v2018), and the Organ Procurement and Transplantation Network (OPTN) criteria. All magnetic resonance imaging and computed tomography reports using a standardized LI‐RADS macro between April 2015 and March 2018 were identified retrospectively. The major features (size, arterial phase hyperenhancement, washout, enhancing capsule, or threshold growth) were extracted from the report for each LR‐3, LR‐4, and LR‐5 observation. Each observation was assigned a new category based on LI‐RADS v2017, v2018, and OPTN criteria. Radiologic T stage was calculated based on the size and number of LR‐5 or OPTN class 5 observations. Categories and T stages assigned by each system were compared descriptively. There were 398 patients (66.6% male; mean age, 63.4 years) with 641 observations (median size, 14 mm) who were included. A total of 73/182 (40.1%) observations categorized LR‐4 by LI‐RADS v2017 were up‐categorized to LR‐5 by LI‐RADS v2018 due to changes in the LR‐5 criteria, and 4/196 (2.0%) observations categorized as LR‐5 by LI‐RADS v2017 were down‐categorized to LR‐4 by LI‐RADS v2018 due to changes in the threshold growth definition. The T stage was higher by LI‐RADS v2018 than LI‐RADS v2017 in 49/398 (12.3%) patients. Compared with the OPTN stage, 12/398 (3.0%) patients were upstaged by LI‐RADS v2017 and 60/398 (15.1%) by LI‐RADS v2018. Of 101 patients, 5 (5.0%) patients with T2 stage based on LI‐RADS v2017 and 10/102 (9.8%) patients with T2 stage based on LI‐RADS v2018 did not meet the T2 criteria based on the OPTN criteria. Of the 98 patients with a T2 stage based on OPTN criteria, 2 (2.0%) had a T stage ≥3 based on LI‐RADS v2017 and 6 (6.1%) had a T stage ≥3 based on LI‐RADS v2018.

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Section: Discussionsupporting

confidence: 53%

Liver Imaging Reporting and Data System Version 2018: Impact on Categorization and Hepatocellular Carcinoma Staging

et al. 2019

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“…For those diagnosed as HCC without pathology, the follow‐up imaging demonstrated substantial growth, associated with APHE, and washout or enhancing capsule . The reference standards for LR‐1, LR‐2, and LR‐3 observations were based on typical imaging findings or the absence of progression to a malignant category (LR‐4, LR‐5, or LR‐TIV) during the follow‐up period …”

Section: Methodsmentioning

confidence: 99%

Diagnostic performance of MR for hepatocellular carcinoma based on LI‐RADS v2018, compared with v2017

Ren

Zhao

Yang

et al. 2019

Magnetic Resonance Imaging

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Background The Liver Imaging Reporting and Data System (LI‐RADS) is widely adopted for noninvasive diagnosis of hepatocellular carcinoma (HCC). It's updated to version 2018 recently, with some major changes compared with v2017. However, the diagnostic performance of LI‐RADS v2018 and its difference with v2017 are yet to be validated. Purpose To compare the diagnostic performances of LI‐RADS on MR for diagnosing HCC between v2017 and v2018. Study Type Retrospective. Subjects In all, 181 patients with 217 hepatic observations (146 HCCs, 16 non‐HCC malignancies and 55 benign lesions) with liver MRI and pathological or follow‐up imaging diagnoses. Field Strength/Sequence 1.5 T or 3 T MRI. Dual‐echo T1WI, T2WI, diffusion‐weighted imaging, and a liver acquisition with volume acceleration. AssessmentImages were independently interpreted by three radiologists, and then in consensus for observations with different LR categories, according to LI‐RADS v2017 and v2018, separately. Statistical Tests Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), and Youden index. Results When adopting LR‐5 as a predictor of HCC, the sensitivity (80.8% vs. 71.2%), NPV (69.6% vs. 60.7%), and accuracy (83.9% vs. 77.9%) were all increased for LI‐RADS v2018 compared with v2017, with a greater Youden index (0.709 vs. 0.627). However, the diagnostic performances of MRI for diagnosing HCC were not changed while adopting LR‐4/5 as a predictor. The threshold growths of 76% (19/25) observations in v2017 were revised to subthreshold growth in v2018, and 16 LR‐4 observations in v2017 were changed to LR‐5 based on v2018. Data Conclusion The diagnostic performance of LI‐RADS v2018 for diagnosing HCC is superior to v2017, with a greater sensitivity, NPV, and accuracy. The revisions in v2018 mainly affect the categorization when adopting LR‐5 as a predictor of HCC. Level of Evidence: 4 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:746–755.

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“…The number of observations per case set was selected to represent a large sample of observations but not more than could be reasonably completed in one review session. The finalized case sets were displayed in a standardized format and were subsequently converted from Table 4 Interrater Reliability for Assigning LI-RADS Categories and Major Features In all stratifications, LR-1 and LR-2 were pooled because they represent observations that were probably or definitely benign and would require no follow-up (17). Similarly, LR-5 and LR-5V were pooled because they represent definite HCC and would require no biopsy according to current clinical practice guidelines.…”

Section: Case Review Formsmentioning

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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Imaging Outcomes of Liver Imaging Reporting and Data System Version 2014 Category 2, 3, and 4 Observations Detected at CT and MR Imaging

Cited by 88 publications

References 19 publications

Liver Imaging Reporting and Data System Version 2018: Impact on Categorization and Hepatocellular Carcinoma Staging

Liver Imaging Reporting and Data System Version 2018: Impact on Categorization and Hepatocellular Carcinoma Staging

Diagnostic performance of MR for hepatocellular carcinoma based on LI‐RADS v2018, compared with v2017

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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