Liver imaging reporting and data system category M: A systematic review and meta‐analysis

Kim, Dong Hwan; Choi, Sang Hyun; Kim, Kyung Won; Byun, Jae Ho; Kim, So Yeon; Lee, Seung Soo; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo‐Nyun

doi:10.1111/liv.14420

Cited by 24 publications

(24 citation statements)

References 27 publications

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“…Meanwhile, rim APHE on CEUS showed the lowest pooled frequency (30%) in non-HCC malignancies. This finding contrasts with the results of a previous meta-analysis using CT/MRI, where rim APHE had the highest frequency in non-HCC malignancies [ 8 ]. Differences in imaging modalities and contrast agent properties may have contributed to the observed differences in the frequencies of imaging features using CEUS or CT/MRI.…”

Section: Discussioncontrasting

confidence: 99%

“…The present meta-analysis revealed that the proportion of overall malignancies in the CEUS LR-M category was high (94%), with similarity to the proportion of the CT/MRI LR-M (93%) category reported in a previous meta-analysis [ 23 ]. However, the pooled proportion of HCC in the LR-M category was higher using the CEUS LI-RADS (54%) than the CT/MRI LI-RADS (22%-36%), and the pooled proportion of non-HCC malignancies was lower using the CEUS LI-RADS (40%) than the CT/MRI LI-RADS (57%-77%) [ 8 , 23 , 24 ]. This discrepancy in the pooled proportion between CEUS and CT/MRI LI-RADS was similar in the subgroup analysis of the present study that included only cohort studies (HCC 59% and non-HCC malignancies 36% in the CEUS LR-M).…”

Section: Discussionmentioning

confidence: 99%

“…of HCC in the LR-M category was higher using the CEUS LI-RADS (54%) than the CT/MRI LI-RADS (22%-36%), and the pooled proportion of non-HCC malignancies was lower using the CEUS LI-RADS (40%) than the CT/MRI LI-RADS (57%-77%) [8,23,24]. This discrepancy of the pooled proportion between CEUS and CT/MRI LI-RADS was similar in our subgroup analysis including only cohort studies, HCC (59%) and non-HCC malignancies (36%) in the CEUS LR-M.…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 94%

“…A recent meta-analysis reported the pooled percentages of HCC and non-HCC malignancies in the LR-M category using MRI [ 8 ]. However, no previous meta-analysis has evaluated the pooled proportions of HCC and non-HCC malignancies categorized as CEUS LR-M or the frequency of each CEUS LR-M imaging feature.…”

Section: Introductionmentioning

confidence: 99%

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Contrast-enhanced ultrasound Liver Imaging Reporting and Data System category M: a systematic review and meta-analysis

et al. 2022

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We performed a meta-analysis to determine the proportion of identifying contrastenhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) category M (LR-M) in hepatocellular carcinomas (HCCs) and non-HCC malignancies and to determine the frequency of individual CEUS LR-M imaging features. Methods: We searched MEDLINE and EMBASE databases from inception to July 23, 2020, for studies reporting the proportion of CEUS LR-M in HCC and non-HCC malignancies. The meta-analytic pooled proportions of HCC and non-HCC malignancies in the CEUS LR-M category were calculated. The meta-analytic frequencies of CEUS LR-M imaging features in non-HCC malignancies were also determined. Risk of bias and applicability were evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: We identified 12 studies reporting the diagnostic performance of the CEUS LR-M category and seven studies reporting the frequencies of individual CEUS LR-M imaging features. The pooled proportions of HCC and non-HCC malignancies in the CEUS LR-M category were 54% (95% confidence interval [CI], 44%-65%) and 40% (95% CI, 28%-53%),respectively. The pooled frequencies of individual CEUS LR-M imaging features in non-HCC malignancies were 30% (95% CI, 17%-45%) for rim arterial phase hyperenhancement, 79% (95% CI, 66%-90%) for early (< 60 s) washout, and 42% (95% CI, 21%-64%) for marked washout. Conclusion:For lesions categorized as CEUS LR-M, 94% were malignancies, with HCCs representing 54% and non-HCC malignancies representing 40%. The frequencies of individual CEUS LR-M imaging features were variable, with early washout showing the highest frequency for non-HCC malignancies.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: A C C E P T E D a R T I C L Ementioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Contrast-enhanced ultrasound Liver Imaging Reporting and Data System category M: a systematic review and meta-analysis

et al. 2022

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“…Another two meta-analyses determined the sensitivity and specificity of LR5 for diagnosing HCC using CT/MRI LI-RADS and CEUS LI-RADS, respectively [15,16]. Kim et al focused on the probability of HCC and OM in the LRM based on MRI [17]. Nevertheless, no systematic review or meta-analysis has compared the diagnostic performance of CEUS LI-RADS and CT/MRI LI-RADS for characterizing HCC and OM.…”

Section: Introductionmentioning

confidence: 99%

Clinical Application of Liver Imaging Reporting and Data System for Characterizing Liver Neoplasms: A Meta-Analysis

Peng

Zhou

2021

Diagnostics

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The Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system for standardizing liver imaging in patients at risk of developing hepatocellular carcinoma (HCC). We aimed to determine the diagnostic performance of LI-RADS category 5 (LR5) for diagnosing HCC and LI-RADS category M (LRM) for characterizing other non-HCC malignancies (OM) using contrast-enhanced ultrasound (CEUS) and computed tomography (CT)/magnetic resonance imaging (MRI). Multiple databases were searched for articles evaluating the diagnostic accuracy of CEUS LI-RADS and/or CT/MRI LI-RADS. A random-effects model was adopted to synthesize the summary estimates of the diagnostic accuracy of LR5 for diagnosing HCC and LRM for characterizing OM using CEUS and CT/MRI. The pooled sensitivity and specificity of CEUS LR5 for the diagnosis of HCC were 69% and 93%, respectively. The pooled sensitivity was 67% and the specificity, 93% of CT/MRI LR5 for HCC diagnosis. There was no significant difference between the overall diagnostic accuracy for HCC diagnosis of CEUS LR5 and that of CT/MRI LR5 in terms of diagnostic odds ratio (DOR) (p = 0.55). The sensitivity was 84% with a specificity of 90% in the CEUS LRM for characterizing OM, while the sensitivity and specificity of CT/MRI LRM for characterizing OM was 63% and 95%. The DOR of CEUS LRM for characterizing OM was higher than that of CT/MRI LRM without significant difference (50.59 vs. 36.06, p = 0.34). This meta-analysis indicated that CEUS LI-RADS is qualified to characterize HCC and OM and may provide complementary information on liver nodules to CT/MRI LI-RADS.

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Characteristics and Early Recurrence of Hepatocellular Carcinomas Categorized as LR‐M: Comparison with Those Categorized as LR‐4 or 5

Shin

Lee

Kim

et al. 2021

Magnetic Resonance Imaging

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Background According to the Liver Imaging Reporting and Data System (LI‐RADS), the LI‐RADS category M (LR‐M), which are probably or definitely malignant but are not specific for hepatocellular carcinomas (HCCs), does not exclude HCCs. A gap in knowledge remains, including their characteristics and recurrence of HCCs categorized as LR‐M. Purpose To compare the characteristics of HCCs categorized as LR‐M with HCCs categorized as LR‐4 or LR‐5 (LR‐4/5) using the LI‐RADS version 2018 and evaluate the relationship of these categories with the risk of early recurrence after curative resections of single HCCs. Study Type Retrospective. Subjects Two hundred and eighty‐one patients (mean age, 57 years; 191 men and 90 women) who underwent curative resections for single HCCs and preoperative contrast‐enhanced MRI between 2015 and 2017. Field Strength/Sequence 3T Dual gradient‐echo T1WI with in‐ and opposed‐phase, turbo spin‐echo T2WI, diffusion‐weighted echo‐planar images, and three‐dimensional gradient‐echo T1WI before and after administration of contrast agent. Assessment MRI features according to the LI‐RADS version 2018 were evaluated and LI‐RADS category were assigned for each observation. Clinical, imaging, and histopathological features were compared based on LI‐RADS categorization. Early recurrence rates (<2 years) and associated factors were also evaluated. Statistical Tests Fisher's exact test, two‐sample t test after satisfying assumption of normality through Shapiro–Wilk test, Fleiss κ coefficient, Cox proportional hazards regression analysis, Kaplan–Meier method, and log‐rank test. Results Forty‐one HCCs (14.6%) were categorized as LR‐M and 240 HCCs (85.4%) were categorized as LR‐4/5. LR‐M HCCs showed poorer differentiation than LR‐4/5 HCCs. In the multivariate analysis, the LR‐M category was an independent predictor for early recurrence (hazard ratio, 1.904; 95% confidence interval, 1.024–3.542; P < 0.05). Early recurrence rates were significantly higher in patients with LR‐M HCCs than in patients with LR‐4/5 HCCs (32.0% vs. 18.4%, respectively, P < 0 05). Data Conclusion Compared to LR‐4/5 HCCs, LR‐M HCCs were associated with poorer tumor differentiation and higher early recurrence rates after curative resections of single HCCs. Level of Evidence: 3 Technical Efficacy Stage: 2

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Liver imaging reporting and data system category M: A systematic review and meta‐analysis

Cited by 24 publications

References 27 publications

Contrast-enhanced ultrasound Liver Imaging Reporting and Data System category M: a systematic review and meta-analysis

Contrast-enhanced ultrasound Liver Imaging Reporting and Data System category M: a systematic review and meta-analysis

Clinical Application of Liver Imaging Reporting and Data System for Characterizing Liver Neoplasms: A Meta-Analysis

Characteristics and Early Recurrence of Hepatocellular Carcinomas Categorized as LR‐M: Comparison with Those Categorized as LR‐4 or 5

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