The utility of diffusion-weighted imaging in improving the sensitivity of LI-RADS classification of small hepatic observations suspected of malignancy

Basha, Mohammad Abd Alkhalik; Refaat, Rania; Mohammad, Faten Fawzy; Khamis, Mai E.M.; El-Maghraby, Ahmed Mohamed; Sammak, Ahmed A El; Almolla, Rania M.; Mohamed, Heba A.; Alnaggar, Ahmad Abdullah; Hassan, Heba; Azmy, Taghreed M.; Eldin, Ahmed M. Alaa; Assy, Mostafa Mohamad; AlAzzazy, Mohamad Zakarya; Altaher, Khaled Mohamed; Tantawy, Heba F.; Saber, Sameh; Amin, Mohamed A.; Alsowey, Ahmed Mohamed; Radwan, Mohamed; Taha, Heba; Fathy, Talaat; Hanafy, Amr Shaaban; Abdelbary, Eman Hassan

doi:10.1007/s00261-018-01887-z

Cited by 17 publications

(11 citation statements)

References 32 publications

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“…Previous studies have demonstrated that use of LI-RADS improved the diagnostic performance of HCC and reclassified high-risk liver nodules with the help of ancillary features on imaging (22)(23)(24). It was also found that, compared with other noninvasive imaging diagnostic methods, LI-RADS shows better sensitivity and accuracy in LR-5 category diagnosis and characterization, which has mostly been attributed to the application of diffusion-weighted imaging (25) and hepatobiliary phase scanning (26). The primary purpose of developing LI-RADS TRA is to improve the interobserver agreement in the interpretation of imaging features on CT/MRI so as to provide clinicians with more reliable tumor response evaluation and curative efficacy prediction.…”

Section: Discussionmentioning

confidence: 98%

Performance of LI-RADS version 2018 CT treatment response algorithm in tumor response evaluation and survival prediction of patients with single hepatocellular carcinoma after radiofrequency ablation

Zhang¹,

Wang

et al. 2020

Ann Transl Med

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Background: The Liver Imaging Reporting and Data System treatment response algorithm (LI-RADS TRA) was developed to evaluate the tumor response of patients with hepatocellular carcinoma (HCC) after locoregional treatments. This study aimed to evaluate the performance of LI-RADS computed tomography (CT) TRA version 2018 in tumor response assessment and survival prediction of patients with single HCC after radiofrequency ablation (RFA). Methods: Forty patients who underwent RFA for single HCC between 2010 and 2016 were included in this retrospective study. The overall survival (OS) data from all the patients after the first therapy was collected. Two readers independently assessed the pretreatment (within 7 d) and posttreatment (within 90 d after RFA) CT manifestations using the LI-RADS version 2018 CT TRA. Inter-reader agreement was assessed. Another radiologist re-evaluated any divergent results and came to the final conclusion. The performance of LI-RADS version 2018 CT TRA for tumor response assessment and predicting survival of patients with single HCC after RFA was evaluated. Results: Interobserver agreement was moderate between the 2 readers [κ=0.602, 95% confidence interval (CI): 0.390-0.814] when using LI-RADS version 2018 TRA to evaluate tumor response for patients with single HCC after RFA. Patients classified as LR-TR viable had significantly lower OS than those classified as LR-TR nonviable (P=0.

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Section: Discussionmentioning

confidence: 98%

Performance of LI-RADS version 2018 CT treatment response algorithm in tumor response evaluation and survival prediction of patients with single hepatocellular carcinoma after radiofrequency ablation

Zhang¹,

Wang

et al. 2020

Ann Transl Med

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“…There was a total of 2,447 articles remaining following the removal of duplicates and a further 2,328 articles were excluded, following screening of the abstract. Amongst the remaining 119 studies, a total of 10 studies were included in the meta-analysis using the inclusion criteria ( 7 , 8 , 14 – 21 ).…”

Section: Resultsmentioning

confidence: 99%

“…In addition, the diagnostic value of DWI combined with contrast-enhanced MRI was assessed by comparing the diagnostic performance of DWI with contrast-enhanced MRI to contrast-enhanced MRI only. The calculation of TP, FP, TN and FN for the contrast-enhanced MRI was only available for 8 of the 10 included studies (7,8,(14)(15)(16)(17)(18)(19). Multilevel mixed-effects logistic regression analysis was used to compare the summary paired sensitivity/specificity data with a significance level of P<0.05.…”

Section: A Meta-analysis Of the Added Value Of Diffusion Weighted Imamentioning

confidence: 99%

A meta‑analysis of the added value of diffusion weighted imaging in combination with contrast‑enhanced magnetic resonance imaging for the diagnosis of small hepatocellular carcinoma lesser or equal to 2 cm

Lan¹,

Lin

Zhong³

2020

Oncol Lett

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Diffusion weighted imaging (DWI) has been found to increase the sensitivity in the diagnosis of small hepatocellular carcinoma (HCC), although additional studies are required to confirm its value. The aim of the present study was to explore the diagnostic performance of DWI combined with contrast-enhanced magnetic resonance imaging (MRI) for small HCC by performing a meta-analysis. Literature databases (PubMed, Embase, Web of Science and Cochrane Library databases) were searched to identify studies reporting the sensitivity and specificity of MRI with DWI for the diagnosis of small HCCs. Pooled sensitivity and specificity were generated using a bivariate random effect model. Multilevel mixed-effects logistic regression analysis was used to examine the value of DWI combined with conventional MRI. A total of 837 small HCCs and 545 benign liver lesions from 10 studies were included. The overall sensitivity and specificity of DWI combined with contrast-enhanced MRI was 0.88 (95% CI, 0.80-0.93) and 0.90 (95% CI, 0.81-0.95), respectively. Compared with that in contrast-enhanced MRI, DWI with contrast-enhanced MRI had a significantly higher sensitivity for the diagnosis of small HCC (P= 0.01) while there was no significant difference in the specificity (P= 0.603). The present meta-analysis suggests that DWI combined with contrast-enhanced MRI may increase the sensitivity, whilst maintaining high specificity for the diagnosis of small HCCs with a diameter ≤2 cm.

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“…19,21 Previous research has demonstrated the clinical potential of mono-exponential DWI or histogram analysis in evaluating the therapeutic response of HCC (for example: TACE or other novel targeted therapies) 22 and diagnostic value in combination with LI-RADS. 23,25 However, hardly ever were IVIM-derived histogram metrics applied for addressing the above issues. In view of the important functional insights provided by IVIM as well as the numerous potential quantitative markers provided by histogram analysis, IVIM-derived histogram metrics held great potential in accurately diagnosing patients with HCC of different grades in the LI-RADS category and evaluating the therapeutic response of TACE and other novel therapies.…”

Section: Diagnostic Performance Analysismentioning

confidence: 99%

<p>Evaluation of Multiple Prognostic Factors of Hepatocellular Carcinoma with Intra-Voxel Incoherent Motions Imaging by Extracting the Histogram Metrics</p>

Shi¹,

Han²,

Wang³

et al. 2020

CMAR

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To predict multiple prognostic factors of HCC including histopathologic grade, the expression of Ki67 as well as capsule formation with intravoxel incoherent motions imaging by extracting the histogram metrics. Patients and Methods: A total of 52 patients with HCC were recruited with the MR examinations undertaken at a 3T scanner. Histogram metrics were extracted from IVIMderived parametric maps. Independent student t-test was performed to explore the differences in metrics across different subtypes of prognostic factors. Spearman correlation test was utilized to evaluate the correlations between the IVIM metrics and prognostic factors. ROC analysis was applied to evaluate the diagnostic performance. Results: According to the independent student t-test, there were 18, 4, and 8 IVIM-derived histogram metrics showing the capability for differentiating the subtypes of histopathologic grade, Ki67, and capsule formation, respectively, with P-values of less than 0.05. Besides, there existed a lot of significant correlations between IVIM metrics and prognostic factors. Finally, by integrating different histogram metrics showing significant differences between various subgroups together via establishing logistic regression based diagnostic models, greatest diagnostic power was obtained for grading HCC (AUC=0.917), diagnosing patients with highly expressed Ki67 (AUC=0.861) and diagnosing patients with capsule formation (AUC=0.839). Conclusion: Multiple prognostic factors including histopathologic grade, Ki67 expression status, and capsule formation can be accurately predicted with assistance of histogram metrics sourced from a single IVIM scan.

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The utility of diffusion-weighted imaging in improving the sensitivity of LI-RADS classification of small hepatic observations suspected of malignancy

Cited by 17 publications

References 32 publications

Performance of LI-RADS version 2018 CT treatment response algorithm in tumor response evaluation and survival prediction of patients with single hepatocellular carcinoma after radiofrequency ablation

Performance of LI-RADS version 2018 CT treatment response algorithm in tumor response evaluation and survival prediction of patients with single hepatocellular carcinoma after radiofrequency ablation

A meta‑analysis of the added value of diffusion weighted imaging in combination with contrast‑enhanced magnetic resonance imaging for the diagnosis of small hepatocellular carcinoma lesser or equal to 2 cm

<p>Evaluation of Multiple Prognostic Factors of Hepatocellular Carcinoma with Intra-Voxel Incoherent Motions Imaging by Extracting the Histogram Metrics</p>

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