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The Liver Imaging Reporting and Data System tumor-in-vein category: a systematic review and meta-analysis

  • Hepatobiliary-Pancreas
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Abstract

Objectives

We aimed to systematically determine the etiology of the Liver Imaging Reporting and Data System (LI-RADS) tumor-in-vein category (LR-TIV) on contrast-enhanced CT or MRI and to determine the sources of heterogeneity between reported results.

Methods

Original studies reporting the etiology of LR-TIV were identified in MEDLINE and EMBASE up until July 7, 2020. The meta-analytic pooled percentages of HCC and non-HCC in LR-TIV were calculated. Subgroup analyses were performed according to the type of reference standard and the most common underlying liver disease. Meta-regression analysis was performed to explore study heterogeneity.

Results

Sixteen studies reported the etiology of a total of 150 LR-TIV, of which 98 (65%) were HCC and 52 (35%) were non-HCC. The meta-analytic pooled percentages of HCC and non-HCC in LR-TIV were 70.9% (95% confidence interval [CI], 55.7–82.5%; I2 = 59%) and 29.2% (95% CI, 17.5–44.4%; I2 = 59%), respectively. The meta-analytic pooled percentage of HCC was lower in studies using only pathology as a reference standard (67.1%; 95% CI, 49.3–81.1%), but higher in studies in which hepatitis C was the most common underlying liver disease (81.9%; 95% CI, 11.3–99.4%) than that in the total 16 studies. Study type (cohort study versus case-control study) was significantly associated with study heterogeneity (p = 0.04).

Conclusion

The most common etiology of LR-TIV was HCC. It might be important to understand the percentage of HCC and non-HCC in LR-TIV in consideration of the type of reference standard, geographic differences, and study design.

Key Points

• The most common etiology of Liver Imaging Reporting and Data System (LI-RADS) tumor-in-vein category (LR-TIV) was hepatocellular carcinoma (HCC).

• The percentage of HCC in LR-TIV was relatively low in studies using only pathology as a reference standard, but high in studies in which hepatitis C was the most common underlying liver disease.

• Study type was a factor significantly influencing study heterogeneity.

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Abbreviations

CI:

Confidence interval

CT:

Computed tomography

HCC:

Hepatocellular carcinoma

LI-RADS:

Liver Imaging Reporting and Data System

MRI:

Magnetic resonance imaging

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

QUADAS:

Quality Assessment of Diagnostic Accuracy Studies

TIV:

Tumor in vein

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Acknowledgments

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (grant number: NRF-2019R1G1A1099743), and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C2383).

Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (grant number: NRF-2019R1G1A1099743), and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C2383).

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Authors and Affiliations

  1. 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

    Dong Hwan Kim, Sang Hyun Choi, Seong Ho Park, Kyung Won Kim, Jae Ho Byun, So Yeon Kim & Seung Soo Lee

  2. 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

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  1. Dong Hwan Kim
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Correspondence to Sang Hyun Choi.

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The scientific guarantor of this publication is Sang Hyun Choi.

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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

One of the authors (Sang Hyun Choi) has significant statistical expertise.

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Written informed consent was not required for this study because this study was meta-analysis.

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Institutional Review Board approval was not required because this study was meta-analysis.

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• retrospective

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• multicenter study

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Kim, D.H., Choi, S.H., Park, S.H. et al. The Liver Imaging Reporting and Data System tumor-in-vein category: a systematic review and meta-analysis. Eur Radiol 31, 2497–2506 (2021). https://doi.org/10.1007/s00330-020-07282-x

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  • DOI: https://doi.org/10.1007/s00330-020-07282-x

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