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Characterization of liver nodules in patients with chronic liver disease by MRI: performance of the Liver Imaging Reporting and Data System (LI-RADS v.2018) scale and its comparison with the Likert scale

La radiologia medica volume 125, pages 15–23 (2020)Cite this article

Abstract

Objectives

To evaluate the performance of the LI-RADS v.2018 scale by comparing it with the Likert scale, in the characterization of liver lesions.

Methods

A total of 39 patients with chronic liver disease underwent MR examination for characterization of 44 liver lesions. Images were independently analyzed by two radiologists using the LI-RADS scale and by another two radiologists using the Likert scale. The reference standard used was either histopathological evaluation or a 4-year MRI follow-up. Receiver operating characteristic analysis was performed.

Results

The LI-RADS scale obtained an accuracy of 80%, a sensitivity of 72%, a specificity of 93%, a positive predictive value (PPV) of 93% and a negative predictive value (NPV) of 70%, while the Likert scale achieved an accuracy of 79%, a sensitivity of 73%, a specificity of 87%, a PPV of 89% and a NPV of 70%. The area under the curve (AUC) was 85% for the LI-RADS scale and 83% for the Likert scale. The inter-observer agreement was strong (k = 0.89) between the LI-RADS evaluators and moderate (k = 0.69) between the Likert evaluators.

Conclusions

There was no statistically significant difference between the performances of the two scales; nevertheless, we suggest that the LI-RADS scale be used, as it appeared more objective and consistent.

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Fig. 1

Abbreviations

LI-RADS:

Liver Imaging Reporting and Data System

ROC:

Receiver operating characteristic

PPV:

Positive predictive value

NPV:

Negative predictive value

AUC:

Area under the curve

HCC:

Hepatocellular carcinoma

ACC:

Accuracy

SENS:

Sensitivity

SPEC:

Specificity

FNB:

Fine-needle biopsy

HCV:

Hepatitis C virus

HBV:

Hepatitis B virus

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Funding

This study did not receive any funding.

Author information

Affiliations

  1. Division of Radiology, Foundation IRCCS Ca’ Granda Maggiore Policlinico Hospital, Via F.Sforza 35, Milan, Italy

    Andrea Esposito & Laura Forzenigo

  2. Division of Radiology, Sant’Andrea Hospital, Corso M. Abbiate 21, Vercelli, Italy

    Valentina Buscarino

  3. Division of Radiology, Città di Sesto San Giovanni Hospital, Viale G. Matteotti 83, Sesto San Giovanni, Italy

    Dario Raciti

  4. Department of Computer Science (DI), University of Milan, Via G. Celoria 18, Milan, Italy

    Elena Casiraghi

  5. Departement of Specialty and Transplant Medicine, Gastroenterology, Hepatology and Transplant Unit, Papa Giovanni XXIII Hospital, Piazza OMS 1, Bergamo, Italy

    Matteo Manini

  6. Division of Radiology, Abano Terme Policlinico Hospital, Piazza C. Colombo 1, Abano Terme, Italy

    Pietro Biondetti

Authors
  1. Andrea Esposito
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  2. Valentina Buscarino
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  3. Dario Raciti
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  4. Elena Casiraghi
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  7. Laura Forzenigo
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Correspondence to Andrea Esposito.

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This article does not contain any studies with animals performed by any of the authors. All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Esposito, A., Buscarino, V., Raciti, D. et al. Characterization of liver nodules in patients with chronic liver disease by MRI: performance of the Liver Imaging Reporting and Data System (LI-RADS v.2018) scale and its comparison with the Likert scale. Radiol med 125, 15–23 (2020). https://doi.org/10.1007/s11547-019-01092-y

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Keywords

  • Liver cirrhosis
  • Carcinoma, hepatocellular
  • Magnetic resonance imaging
  • Early detection of cancer
  • Data interpretation, statistical