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Inter-reader agreement of abbreviated magnetic resonance imaging for hepatocellular carcinoma detection: a systematic review and meta-analysis

  • Hepatobiliary
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To determine the inter-reader agreement of abbreviated magnetic resonance imaging (AMRI) for the detection of hepatocellular carcinoma (HCC) and explore the causes of heterogeneity between the reported results.

Methods

Original studies reporting the inter-reader agreement of AMRI for detecting HCC were identified in MEDLINE, EMBASE, and Cochrane databases. The pooled kappa coefficient (κ) was calculated using the DerSimonian–Laird random-effects model. Subgroup analyses were performed according to the AMRI protocol (non-contrast [NC]-AMRI, dynamic contrast-enhanced [DCE]-AMRI, and hepatobiliary phase [HBP]-AMRI). Meta-regression analyses were performed to further explore study heterogeneity.

Results

In the eight included studies (1182 patients), the overall pooled κ was 0.76 (95% confidence interval [CI], 0.70–0.82; I2 = 74.4%). The κ of NC-AMRI, DCE-AMRI, and HBP-AMRI were 0.72 (95% CI, 0.62–0.82), 0.80 (95% CI, 0.78–0.82), and 0.98 (95% CI, 0.95–1.00), respectively. In the NC-AMRI, the pooled κ of NC-AMRI using only diffusion-weighted imaging (DWI) was 0.64, which was lower than the values using two or more imaging sequences (κ = 0.74–0.77). In subgroup analysis, no study heterogeneity was noted in studies using DCE-AMRI (I2 = 0%), whereas high heterogeneity was noted with NC-AMRI (I2 = 80.5%). Especially, NC-AMRI including more than two imaging sequences showed high residual heterogeneity (I2 = 87.6%). Meta-regression analysis found that difference in reader experience was significantly associated with study heterogeneity (p = .02).

Conclusion

AMRI for detecting HCC showed substantial inter-reader agreement across all examined protocols. NC-AMRI, notably NC-AMRI using only DWI, had relatively low inter-reader agreement. Therefore, DCE-AMRI or HBP-AMRI may be more reliable than NC-AMRI using only DWI.

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Abbreviations

AMRI:

Abbreviated magnetic resonance imaging

CI:

Confidence interval

CT:

Computed tomography

DCE:

Dynamic contrast-enhanced

DWI:

Diffusion-weighed imaging

HBP:

Hepatobiliary phase

HCC:

Hepatocellular carcinoma

NC:

Non-contrast

MRI:

Magnetic resonance imaging

T2WI:

T2-weighted imaging

US:

Ultrasound

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Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (Grant Number: NRF-2019R1G1A1099743).

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Authors and Affiliations

  1. Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Dong Hwan Kim & Joon-Il Choi

  2. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea

    Sang Hyun Choi

  3. Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea

    Ji Sung Lee

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  1. Dong Hwan Kim
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Correspondence to Sang Hyun Choi.

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Kim, D.H., Choi, S.H., Lee, J.S. et al. Inter-reader agreement of abbreviated magnetic resonance imaging for hepatocellular carcinoma detection: a systematic review and meta-analysis. Abdom Radiol 47, 123–132 (2022). https://doi.org/10.1007/s00261-021-03297-0

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