European Radiology

, Volume 28, Issue 5, pp 2038–2046 | Cite as

Diagnostic accuracy of prospective application of the Liver Imaging Reporting and Data System (LI-RADS) in gadoxetate-enhanced MRI

  • Yeun-Yoon Kim
  • Chansik An
  • Sungwon Kim
  • Myeong-Jin Kim
Gastrointestinal

Abstract

Objectives

To evaluate the diagnostic performance of the LI-RADS (v2014) on gadoxetate-enhanced MRI prospectively applied in actual practice.

Methods

We retrospectively reviewed the prospectively written radiology reports of 143 treatment-naïve at-risk patients who underwent gadoxetate-enhanced liver MRI from January to December 2014, and identified 202 hepatic observations categorized using the LI-RADS. The diagnostic performances of LI-RADS categories for hepatocellular carcinoma (HCC) and hepatic malignancy were calculated.

Results

Twenty (69.0 %) of 29 LR-4, 73 (97.3 %) of 75 LR-5, and all of five (100 %) LR-5V observations were HCCs. The remaining two (2.7 %) LR-5 observations were combined hepatocellular-cholangiocarcinomas, while 10 (76.9 %) of 13 LR-M observations were HCCs. The sensitivity and specificity of LR-5/5V for HCC were 60.5 % and 97.3 %, respectively. Including LR-M in the diagnostic criteria for HCC increased sensitivity (68.2 %, p = 0.002) but decreased specificity without statistical significance (93.2 %, p = 0.154). LR-5/5V/M yielded sensitivity of 68.9 % and specificity of 100.0 % for hepatic malignancy.

Conclusions

LI-RADS v2014 was successfully applied on gadoxetate-enhanced MRI in clinical practice. LR-5/5V was the most specific diagnostic measure for HCC, but most LR-M observations were HCCs and a considerable portion of non-HCC malignancies were categorized as LR-4 or LR-5.

Key Points

LR-5/5V provided a highly specific diagnosis for HCC.

Half of non-HCC malignancies were categorized as LR-4 or LR-5.

The majority of LR-M observations were finally diagnosed as HCCs.

More sensitive diagnosis of HCC was feasible with LR-5/5V/M on gadoxetate-enhanced MRI.

Observations in either LR-5/5V or LR-M categories were definitely malignant.

Keywords

Liver Magnetic resonance imaging Gadolinium DTPA disodium salt Diagnosis Sensitivity and Specificity 

Abbreviations

HCC

Hepatocellular carcinoma

LI-RADS

Liver Imaging Reporting and Data System

LR

LI-RADS category

MRI

Magnetic resonance imaging

Notes

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Myeong-Jin Kim.

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

Ha Yan Kim, M.S. in statistics, kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was waived by the institutional review board.

Ethical approval

Institutional review board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Yeun-Yoon Kim
    • 1
  • Chansik An
    • 1
  • Sungwon Kim
    • 1
  • Myeong-Jin Kim
    • 1
  1. 1.Department of Radiology and Research Institute of Radiological Science, Severance HospitalYonsei University College of MedicineSeoulKorea

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