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Retrospective comparison of EASL 2018 and LI-RADS 2018 for the noninvasive diagnosis of hepatocellular carcinoma using magnetic resonance imaging

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Abstract

Purpose

We compared the diagnostic performances of the European Association for the Study of the Liver (EASL) 2018 and Liver Imaging Reporting and Data System (LI-RADS) 2018 criteria on magnetic resonance imaging (MRI) for the noninvasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients and evaluated the difference in diagnostic value between MRI with extracellular contrast agents (ECA-MRI) and MRI with hepatobiliary agents (HBA-MRI).

Methods

This study included 382 observations from 298 patients at high risk for HCC who underwent preoperative multiphasic contrast-enhanced MRI between January 2015 and December 2016. Two readers assessed all observations according to the EASL 2018 and LI-RADS 2018 criteria, and the per-observation diagnostic performances were compared.

Results

On ECA-MRI, the LR-5 category of LI-RADS 2018 showed significantly higher sensitivity (78.9% vs. 71.5%, p = 0.005) and accuracy (81.7% vs. 75.0%, p = 0.003) for the diagnosis of HCC than the EASL 2018. On HBA-MRI, the diagnostic performances of the EASL 2018 and LR-5 of LI-RADS 2018 were not significantly different. When using EASL 2018, no statistically significant differences were observed in the diagnostic performances between ECA-MRI and HBA-MRI; however, when using the LR-5 of LI-RADS 2018, ECA-MRI had a higher sensitivity (78.9% vs. 67.5%, p = 0.029) than HBA-MRI.

Conclusions

On ECA-MRI, the LR-5 category of LI-RADS 2018 provides better sensitivity and accuracy than the EASL 2018 for diagnosing HCC. EASL 2018 provides comparable diagnostic performances between ECA-MRI and HBA-MRI, but the LR-5 category of LI-RADS 2018 provides better sensitivity on ECA-MRI than on HBA-MRI.

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Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Korea (Grant No. 1520160).

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea

    Sunyoung Lee, Myeong-Jin Kim, Seung-seob Kim, Jin-Young Choi & Mi-Suk Park

  2. Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea

    Hyejung Shin

  3. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea

    Do Young Kim

  4. Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA

    Donald G. Mitchell

Authors
  1. Sunyoung Lee
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  3. Seung-seob Kim
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Contributions

All authors participated in the following: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; drafting the work or revising it critically for important intellectual content; approval of the final version of the manuscript; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The main role of the authors was as follows: 1. guarantor of the integrity of the entire study: M-JK. 2. Study conception and design: SL, M-JK, and SK. 3. Literature search: SL. 4. Clinical studies: SK, DYK, JYC, and MP. 5. Data analysis or interpretation: SK, SL, M-JK, and DGM. 6. Statistical analysis: HS. 7. Manuscript preparation: SL and M-JK. 8. Manuscript review: SL, M-JK, and DGM. 9. Study supervision: DGM.

Corresponding author

Correspondence to Myeong-Jin Kim.

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Conflict of interest

Sunyoung Lee, Seung-seob Kim, Hyejung Shin, Do Young Kim, Jin-Young Choi, Mi-Suk Park, and Donald G. Mitchell declare that they have no conflict of interest. Myeong-Jin Kim received grant and honorarium from Bayer, and honorarium from Guerbet, Philips, SIEMENS, and GE Healthcare.

Ethical approval

This e study was approved by the Severance Hospital, Yonsei University College of Medicine, IRB Number 4-2018-1090).

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The written or oral informed consent was waived.

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Lee, S., Kim, MJ., Kim, Ss. et al. Retrospective comparison of EASL 2018 and LI-RADS 2018 for the noninvasive diagnosis of hepatocellular carcinoma using magnetic resonance imaging. Hepatol Int 14, 70–79 (2020). https://doi.org/10.1007/s12072-019-10002-3

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  • DOI: https://doi.org/10.1007/s12072-019-10002-3

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