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

  • Gastrointestinal
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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.

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Abbreviations

HCC:

Hepatocellular carcinoma

LI-RADS:

Liver Imaging Reporting and Data System

LR:

LI-RADS category

MRI:

Magnetic resonance imaging

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Funding

The authors state that this work has not received any funding.

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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, Korea

    Yeun-Yoon Kim, Chansik An, Sungwon Kim & Myeong-Jin Kim

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  1. Yeun-Yoon Kim
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  2. Chansik An
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  3. Sungwon Kim
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Correspondence to Myeong-Jin Kim.

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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.

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Institutional review board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Kim, YY., An, C., Kim, S. et al. Diagnostic accuracy of prospective application of the Liver Imaging Reporting and Data System (LI-RADS) in gadoxetate-enhanced MRI. Eur Radiol 28, 2038–2046 (2018). https://doi.org/10.1007/s00330-017-5188-y

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  • DOI: https://doi.org/10.1007/s00330-017-5188-y

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