Using new criteria to improve the differentiation between HCC and non-HCC malignancies : clinical practice and discussion in CEUS LI-RADS 2017
© 2021. Italian Society of Medical Radiology..
PURPOSE: Using contrast-enhanced ultrasound (CEUS) to evaluate the diagnostic performance of liver imaging reporting and data system (LI-RADS) version 2017 and to explore potential ways to improve the efficacy.
METHODS: A total of 315 nodules were classified as LR-1 to LR-5, LR-M, and LR-TIV. New criteria were applied by adjusting the early washout onset (< 45 s) and the time of marked washout (within 3 min). Two subgroups of the LR-M nodules were recategorized as LR-5, respectively. The diagnostic performance was evaluated by calculating the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
RESULTS: By adjusting early washout onset to < 45 s, the LR-5 as a standard for diagnosing HCC had an improved sensitivity (74.1% vs. 56.1%, P < 0.001) without significant change in PPV (93.3% vs. 96.1%, P = 0.267), but the specificity was decreased (48.3% vs. 78.5%, P = 0.018). The LR-M as a standard for the diagnosis of non-HCC malignancies had an increase in specificity (89.2% vs. 66.2%, P < 0.001) but a decrease in sensitivity (31.5% vs. 68.4%, P = 0.023). After reclassification according to the time of marked washout, the sensitivity of the LR-5 increased (80% vs. 56.1%, P < 0.001) without a change in PPV (94.9% vs. 96.1%, P = 0.626) and specificity (80% vs. 78.5%, P = 0.879). For reclassified LR-M nodules, the specificity increased (87.5% versus 66.2%, P < 0.001) with a non-significant decrease in sensitivity (47.3% vs. 68.4%, P = 0.189).
CONCLUSIONS: The CEUS LI-RADS showed good confidence in diagnosing HCC while tended to misdiagnose HCC as non-HCC malignancies. Adjusting the marked washout time within 3 min would reduce the possibility of this misdiagnosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:127 |
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| Enthalten in: |
La Radiologia medica - 127(2022), 1 vom: 19. Jan., Seite 1-10 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zeng, Dan [VerfasserIn] |
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| Links: |
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| Themen: |
Contrast Media |
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| Anmerkungen: |
Date Completed 03.02.2022 Date Revised 03.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s11547-021-01417-w |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM332057038 |
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| 100 | 1 | |a Zeng, Dan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Using new criteria to improve the differentiation between HCC and non-HCC malignancies |b clinical practice and discussion in CEUS LI-RADS 2017 |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 03.02.2022 | ||
| 500 | |a Date Revised 03.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. Italian Society of Medical Radiology. | ||
| 520 | |a PURPOSE: Using contrast-enhanced ultrasound (CEUS) to evaluate the diagnostic performance of liver imaging reporting and data system (LI-RADS) version 2017 and to explore potential ways to improve the efficacy | ||
| 520 | |a METHODS: A total of 315 nodules were classified as LR-1 to LR-5, LR-M, and LR-TIV. New criteria were applied by adjusting the early washout onset (< 45 s) and the time of marked washout (within 3 min). Two subgroups of the LR-M nodules were recategorized as LR-5, respectively. The diagnostic performance was evaluated by calculating the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) | ||
| 520 | |a RESULTS: By adjusting early washout onset to < 45 s, the LR-5 as a standard for diagnosing HCC had an improved sensitivity (74.1% vs. 56.1%, P < 0.001) without significant change in PPV (93.3% vs. 96.1%, P = 0.267), but the specificity was decreased (48.3% vs. 78.5%, P = 0.018). The LR-M as a standard for the diagnosis of non-HCC malignancies had an increase in specificity (89.2% vs. 66.2%, P < 0.001) but a decrease in sensitivity (31.5% vs. 68.4%, P = 0.023). After reclassification according to the time of marked washout, the sensitivity of the LR-5 increased (80% vs. 56.1%, P < 0.001) without a change in PPV (94.9% vs. 96.1%, P = 0.626) and specificity (80% vs. 78.5%, P = 0.879). For reclassified LR-M nodules, the specificity increased (87.5% versus 66.2%, P < 0.001) with a non-significant decrease in sensitivity (47.3% vs. 68.4%, P = 0.189) | ||
| 520 | |a CONCLUSIONS: The CEUS LI-RADS showed good confidence in diagnosing HCC while tended to misdiagnose HCC as non-HCC malignancies. Adjusting the marked washout time within 3 min would reduce the possibility of this misdiagnosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Contrast-enhanced ultrasound | |
| 650 | 4 | |a Focal liver lesions | |
| 650 | 4 | |a Liver imaging reporting and data system version 2017 | |
| 650 | 7 | |a Contrast Media |2 NLM | |
| 700 | 1 | |a Xu, Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Jin-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Mei-Qing |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Pan, Jia-Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Yang |e verfasserin |4 aut | |
| 700 | 1 | |a Tong, Wen-Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Xie, Xiao-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Lu, Ming-De |e verfasserin |4 aut | |
| 700 | 1 | |a Kuang, Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Li-Da |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Hang-Tong |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Wei |e verfasserin |4 aut | |
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