Using new criteria to improve the differentiation between HCC and non-HCC malignancies: clinical practice and discussion in CEUS LI-RADS 2017
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: |
Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:127 |
|---|---|
| Enthalten in: |
La Radiologia medica - 127(2021), 1 vom: 19. Okt., Seite 1-10 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Zeng, Dan [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| Themen: |
Contrast-enhanced ultrasound |
|---|
| Anmerkungen: |
© Italian Society of Medical Radiology 2021 |
|---|
| doi: |
10.1007/s11547-021-01417-w |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC2077899611 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | OLC2077899611 | ||
| 003 | DE-627 | ||
| 005 | 20230509124614.0 | ||
| 007 | tu | ||
| 008 | 221220s2021 xx ||||| 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s11547-021-01417-w |2 doi | |
| 035 | |a (DE-627)OLC2077899611 | ||
| 035 | |a (DE-He213)s11547-021-01417-w-p | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q VZ |
| 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: clinical practice and discussion in CEUS LI-RADS 2017 |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a © Italian Society of Medical Radiology 2021 | ||
| 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. 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. | ||
| 650 | 4 | |a Focal liver lesions | |
| 650 | 4 | |a Liver imaging reporting and data system version 2017 | |
| 650 | 4 | |a Contrast-enhanced ultrasound | |
| 700 | 1 | |a Xu, Ming |4 aut | |
| 700 | 1 | |a Liang, Jin-Yu |4 aut | |
| 700 | 1 | |a Cheng, Mei-Qing |4 aut | |
| 700 | 1 | |a Huang, Hui |4 aut | |
| 700 | 1 | |a Pan, Jia-Ming |4 aut | |
| 700 | 1 | |a Huang, Yang |4 aut | |
| 700 | 1 | |a Tong, Wen-Juan |4 aut | |
| 700 | 1 | |a Xie, Xiao-Yan |4 aut | |
| 700 | 1 | |a Lu, Ming-De |4 aut | |
| 700 | 1 | |a Kuang, Ming |4 aut | |
| 700 | 1 | |a Chen, Li-Da |4 aut | |
| 700 | 1 | |a Hu, Hang-Tong |4 aut | |
| 700 | 1 | |a Wang, Wei |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t La Radiologia medica |d Springer Milan, 1914 |g 127(2021), 1 vom: 19. Okt., Seite 1-10 |w (DE-627)129488879 |w (DE-600)205751-7 |w (DE-576)014881853 |x 0033-8362 |7 nnns |
| 773 | 1 | 8 | |g volume:127 |g year:2021 |g number:1 |g day:19 |g month:10 |g pages:1-10 |
| 856 | 4 | 1 | |u https://doi.org/10.1007/s11547-021-01417-w |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 912 | |a SSG-OLC-PHA | ||
| 912 | |a SSG-OLC-DE-84 | ||
| 951 | |a AR | ||
| 952 | |d 127 |j 2021 |e 1 |b 19 |c 10 |h 1-10 | ||