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LI-RADS v2017 categorisation of HCC using CT: Does moderate to severe fatty liver affect accuracy?

  • Computed Tomography
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Abstract

Objectives

To compare the sensitivity of Liver Imaging Reporting and Data System (LI-RADS) v2017 for diagnosis of hepatocellular carcinoma (HCC) using multiphasic computed tomography (CT) between patients with and without moderate to severe fatty liver (MSFL).

Methods

This retrospective study included a total of 106 high-risk patients with 112 pathologically proven HCCs who underwent multiphasic CT. Patients were classified as MSFL (24 men, 2 women; mean age, 59.5 years [range, 38–79 years]) and non-MSFL (64 men, 16 women; mean age, 62.9 years [range, 40–89 years]) groups according to unenhanced CT liver and spleen parenchymal attenuation. Two independent radiologists assigned LI-RADS categories and accessed HCC features on CT. Sensitivities for LR-5 assignment and frequencies of HCC features were compared between the two groups.

Results

Sensitivities of LR-5 assignment for diagnosing HCCs were not significantly different between MSFL and non-MSFL groups (65.4% [17/26] vs. 76.7% [66/86] for reviewer 1, p = 0.247; 73.1% [19/26] vs. 76.74% [66/86] for reviewer 2, p = 0.702). No significant differences in the frequencies of arterial hyperenhancement, washout, and capsule were observed between the two groups (96.2% [25/26] vs. 98.8% [85/86], p = 0.412; 80.8% [21/26] vs. 89.5% [77/86], p = 0.308; and 53.8% [14/26] vs. 57% [49/86], p = 0.778, respectively).

Conclusions

LI-RADS v2017 using CT showed comparable sensitivity for diagnosing HCC regardless of MSFL.

Key Points

• Using LI-RADS v2017 with CT, diagnosis of HCC in patients with MSFL showed similar sensitivity to that in patients without MSFL.

• Frequencies of major HCC features (arterial hyperenhancement, washout, and capsule) on CT between the MSFL and non-MSFL groups were not significantly different.

• LI-RADS using CT may be feasible for diagnosing HCC in patients with fatty liver.

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Abbreviations

CT:

Computed tomography

HCC:

Hepatocellular carcinoma

HU:

Hounsfield units

ICC:

Intraclass correlation coefficient

LC:

Liver cirrhosis

LI-RADS:

Liver Imaging Reporting and Data System

MSFL:

Moderate to severe fatty liver

NAFLD:

Non-alcoholic fatty liver disease

ROI:

Region of interest

TIV:

Tumour in vein

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

This work was supported by the Soonchunhyang University Research Fund.

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Authors and Affiliations

  1. Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Soonchunhyang6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 330-721, Republic of Korea

    Seung Soo Kim, Jeong Ah Hwang, Hyeong Cheol Shin, Sung Shick Jou & Woong Hee Lee

  2. Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea

    Seo-Youn Choi

  3. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Tae Wook Kang

  4. Department of Biomedical Statistics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea

    Suyeon Park

  5. Clinical Trial Center, Soonchunhyang University Cheonan Hospital, Cheonan-si, Chungcheongnam-do, Republic of Korea

    Nam Hun Heo

Authors
  1. Seung Soo Kim
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  2. Jeong Ah Hwang
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  3. Hyeong Cheol Shin
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  4. Seo-Youn Choi
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  7. Woong Hee Lee
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Corresponding author

Correspondence to Seung Soo Kim.

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Guarantor

The specific guarantor of this publication is Sung Shick Jou, the head of the Radiology Department of Soonchunhyang University College of Medicine, Cheonan Hospital, Republic of Korea

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Suyeon Park and Nam Hun Heo kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was waived by the Institutional Review Board because of the retrospective nature of the study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

Retrospective, observational, performed at one institution

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Kim, S.S., Hwang, J.A., Shin, H.C. et al. LI-RADS v2017 categorisation of HCC using CT: Does moderate to severe fatty liver affect accuracy?. Eur Radiol 29, 186–194 (2019). https://doi.org/10.1007/s00330-018-5657-y

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  • DOI: https://doi.org/10.1007/s00330-018-5657-y

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