Interobserver Agreement for Contrast-Enhanced Ultrasound (CEUS)-Based Standardized Algorithms for the Diagnosis of Hepatocellular Carcinoma in High-Risk Patients

Schellhaas, Barbara; Pfeifer, Lukas; Kielisch, C; Goertz, Ruediger S.; Neurath, Markus F.; Strobel, D

doi:10.1055/a-0612-7887

Cited by 28 publications

(30 citation statements)

References 35 publications

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“…Significant heterogeneity was observed in the current metaanalysis of CEUS LI-RADS for HCC and OM. Although the nonthreshold effect did not differ in multiple and single reviewer studies, some studies [21,22] showed that the interobserver agreement regarding CEUS LI-RADS was fair and noted that disagreements were mostly due to different perceptions of washout because CEUS is an imaging modality that depends greatly on the physician's clinical experience. However, the study conducted by Schellhaas et al [13] concluded that the sensitivity of CEUS could improve if "washout" was omitted as a diagnostic criterion.…”

Section: Discussionmentioning

confidence: 95%

Diagnostic Accuracy of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for Differentiating Between Hepatocellular Carcinoma and Other Hepatic Malignancies in High-Risk Patients: A Meta-Analysis

et al. 2020

Ultraschall Med

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Objectives The American College of Radiology (ACR) contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS), which includes diagnostic criteria for hepatocellular carcinoma (HCC) and other hepatic malignancies (OM), is increasingly used in clinical practice. This study performed a meta-analysis to assess the diagnostic accuracy of CEUS LI-RADS for differentiating between HCC and OM in high-risk patients. Methods PubMed, Embase (Ovid), and Cochrane (CENTRAL) were searched for relevant studies. All studies that reported the percentage of HCC and OM in the LI-RADS categories were included. Random-effects models were used to calculate the pooled sensitivity and specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curve. Results Eight studies involving 4215 focal liver lesions were included in the final analysis. The pooled sensitivity and specificity of the LR-5 criteria for HCC were 0.71 (95 % CI, 0.69–0.72) and 0.88 (0.85–0.91), respectively, the DOR was 18.36 (7.41–45.52), and the area under the SROC curve (AUC) was 0.8128. The pooled sensitivity and specificity of the LR-M criteria for OMs were 0.85 (0.81–0.88) and 0.86 (0.85–0.87), the DOR was 27.82 (11.83–65.40), respectively, and the SROC AUC was 0.9098. Conclusion The CEUS LI-RADS can effectively distinguish HCC from other hepatic malignancy in high-risk patients based on LR-5 criteria and LR-M criteria. However, further studies are needed for validation due to the limited number of included studies and the potential heterogeneity among the included studies.

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Section: Discussionmentioning

confidence: 95%

Diagnostic Accuracy of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for Differentiating Between Hepatocellular Carcinoma and Other Hepatic Malignancies in High-Risk Patients: A Meta-Analysis

et al. 2020

Ultraschall Med

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“…In distinction to the late enhancement on CECT or CEMRI, ICC has a variety of patterns in the AP at CEUS but all show washout in the LP [59,113,127]. The typical pattern of malignancy is better displayed by CEUS than by CECT or CEMRI [128,129].…”

Section: Cholangiocarcinoma (Intrahepatic Cholangiocellular Carcinomamentioning

confidence: 97%

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2020 – WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS

et al. 2020

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The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS), first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications.The 2012 guideline requires updating as previously the differences of the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including the United States Food and Drug Administration (FDA) approval as well as the extensive Asian experience, to produce a truly international perspective.These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCA) and are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis to improve the management of patients.

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“…The title and abstract review identified 578 studies, of which 20 full text articles were reviewed (Table ), yielding 14 articles for potential inclusion. Of these, 10 articles 10‐19 were included in the analysis. We also identified one conference abstract from online archives that provided sufficient data for inclusion 20 .…”

Section: Resultsmentioning

confidence: 99%

“…The detailed characteristics of the included studies are presented in Table 1. The 11 studies 10‐20 included a total of 5535 observations with 3983 HCCs. The methodological quality of the studies, which was assessed by the Quality Assessment of Diagnostic Accuracy Studies‐2, is summarized in Figure .…”

Section: Resultsmentioning

confidence: 99%

Contrast‐enhanced ultrasound liver imaging reporting and data system for diagnosing hepatocellular carcinoma: A meta‐analysis

Shin¹,

Lee

Bae

et al. 2020

Liver International

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Background & aims: Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system for standardizing CEUS at high risk for hepatocellular carcinoma (HCC). We performed a meta-analysis to determine the diagnostic performance of the CEUS LR-5 for HCC and the pooled proportions of HCCs in each CEUS LI-RADS category. Methods: We searched multiple databases for studies reporting the diagnostic accuracy of the CEUS LI-RADS. Random-effects model was used to determine summary estimates of the diagnostic performance of CEUS LR-5 and the pooled proportions of HCCs in each CEUS LI-RADS category. Risk of bias and concerns regarding applicability were evaluated with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: Eleven studies were included in the final analysis, which consisted of 5535 observations with 3983 HCCs. The pooled per-observation sensitivity and specificity of the CEUS LR-5 for diagnosing HCC were 69% (95% confidence interval [CI], 64%-73%) and 92% (95% CI, 83%-96%) respectively. The pooled proportions of HCCs were 0% (95% CI, 0-0%) for LR-1, 1% (95% CI, 0%-4%) for CEUS LR-2, 26% (95% CI, 14%-39%) for CEUS LR-3, 77% (95% CI, 68%-86%) for CEUS LR-4, 97% (95% CI, 95%-98%) for CEUS LR-5, 57% (95% CI, 44%-69%) for CEUS LR-M and 100% (95% CI, 93%-100%) for CEUS LR-5V or TIV. Conclusions: The CEUS LR-5 category showed moderate sensitivity and high specificity for diagnosing HCC. The proportion of HCCs was higher in the higher CEUS LI-RADS categories.

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Interobserver Agreement for Contrast-Enhanced Ultrasound (CEUS)-Based Standardized Algorithms for the Diagnosis of Hepatocellular Carcinoma in High-Risk Patients

Cited by 28 publications

References 35 publications

Diagnostic Accuracy of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for Differentiating Between Hepatocellular Carcinoma and Other Hepatic Malignancies in High-Risk Patients: A Meta-Analysis

Diagnostic Accuracy of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for Differentiating Between Hepatocellular Carcinoma and Other Hepatic Malignancies in High-Risk Patients: A Meta-Analysis

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2020 – WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS

Contrast‐enhanced ultrasound liver imaging reporting and data system for diagnosing hepatocellular carcinoma: A meta‐analysis

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