Diagnostic accuracy of prospective application of the Liver Imaging Reporting and Data System (LI-RADS) in gadoxetate-enhanced MRI
To evaluate the diagnostic performance of the LI-RADS (v2014) on gadoxetate-enhanced MRI prospectively applied in actual practice.
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.
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.
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.
• 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.
KeywordsLiver Magnetic resonance imaging Gadolinium DTPA disodium salt Diagnosis Sensitivity and Specificity
Liver Imaging Reporting and Data System
Magnetic resonance imaging
Compliance with ethical standards
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.
Written informed consent was waived by the institutional review board.
Institutional review board approval was obtained.
• performed at one institution
- 2.American College of Radiology (2017) Liver Imaging reporting and data system version 2017. Available via http://www.acr.org/Quality-Safety/Resources/LIRADS. Accessed 1 Jul 2017
- 6.American College of Radiology (2014) Liver imaging reporting and data system version 2014. Available via http://www.acr.org/Quality-Safety/Resources/LIRADS. Accessed 19 Nov 2016
- 7.Joo I, Lee JM, Lee SM, Lee JS, Park JY, Han JK (2016) Diagnostic accuracy of liver imaging reporting and data system (LI-RADS) v2014 for intrahepatic mass-forming cholangiocarcinomas in patients with chronic liver disease on gadoxetic acid-enhanced MRI. J Magn Reson Imaging 44:1330–1338CrossRefPubMedGoogle Scholar
- 10.Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, Lijmer JG, Moher D, Rennie D, de Vet HC, Kressel HY, Rifai N, Golub RM, Altman DG, Hooft L, Korevaar DA, Cohen JF (2015) STARD 2015: An updated list of essential items for reporting diagnostic accuracy studies. Radiology 277:826–832CrossRefPubMedGoogle Scholar
- 17.Potretzke TA, Tan BR, Doyle MB, Brunt EM, Heiken JP, Fowler KJ (2016) Imaging features of biphenotypic primary liver carcinoma (hepatocholangiocarcinoma) and the potential to mimic hepatocellular carcinoma: LI-RADS analysis of CT and MRI features in 81 cases. AJR Am J Roentgenol 207:25–31CrossRefPubMedGoogle Scholar
- 18.International Agency for Research on Cancer (2013) GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon. Available via http://globocan.iarc.fr. Accessed 6 Aug 2017