LI-RADS v2018 category and imaging features: inter-modality agreement between contrast-enhanced CT, gadoxetate disodium-enhanced MRI, and extracellular contrast-enhanced MRI.

IF 9.7 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiologia Medica Pub Date : 2024-11-01 Epub Date: 2024-08-19 DOI:10.1007/s11547-024-01879-8

Francesco Agnello, Roberto Cannella, Giuseppe Brancatelli, Massimo Galia

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引用次数: 0

Abstract

Purpose: To perform an intra-individual comparison of LI-RADS category and imaging features in patients at high risk of hepatocellular carcinoma (HCC) on contrast-enhanced CT, gadoxetate disodium-enhanced MRI (EOB-MRI), and extracellular agent-enhanced MRI (ECA-MRI) and to analyze the diagnostic performance of each imaging modality.

Method: This retrospective study included cirrhotic patients with at least one LR-3, LR-4, LR-5, LR-M or LR-TIV observation imaged with at least two imaging modalities among CT, EOB-MRI, or ECA-MRI. Two radiologists evaluated the observations using the LI-RADS v2018 diagnostic algorithm. Reference standard included pathologic confirmation and imaging criteria according to LI-RADS v2018. Imaging features were compared between different exams using the McNemar test. Inter-modality agreement was calculated by using the weighted Cohen's kappa (k) test.

Results: A total of 144 observations (mean size 34.0 ± 32.4 mm) in 96 patients were included. There were no significant differences in the detection of major and ancillary imaging features between the three imaging modalities. When considering all the observations, inter-modality agreement for category assignment was substantial between CT and EOB-MRI (k 0.60; 95%CI 0.44, 0.75), moderate between CT and ECA-MRI (k 0.46; 95%CI 0.22, 0.69) and substantial between EOB-MRI and ECA-MRI (k 0.72; 95%CI 0.59, 0.85). In observations smaller than 20 mm, inter-modality agreement was fair between CT and EOB-MRI (k 0.26; 95%CI 0.05, 0.47), moderate between CT and ECA-MRI (k 0.42; 95%CI -0.02, 0.88), and substantial between EOB-MRI and ECA-MRI (k 0.65; 95%CI 0.47, 0.82). ECA-MRI demonstrated the highest sensitivity (70%) and specificity (100%) when considering LR-5 as predictor of HCC.

Conclusions: Inter-modality agreement between CT, ECA-MRI, and EOB-MRI decreases in observations smaller than 20 mm. ECA-MRI has the provided higher sensitivity for the diagnosis of HCC.

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LI-RADS v2018 类别和成像特征：对比增强 CT、钆喷酸二钠增强 MRI 和细胞外对比增强 MRI 的模式间一致性。

目的：对比造影剂增强 CT、钆喷酸二钠增强 MRI（EOB-MRI）和细胞外制剂增强 MRI（ECA-MRI）对肝细胞癌（HCC）高风险患者的 LI-RADS 类别和成像特征，并分析每种成像模式的诊断性能：这项回顾性研究纳入了至少有一次LR-3、LR-4、LR-5、LR-M或LR-TIV观察结果的肝硬化患者，他们至少使用了CT、EOB-MRI或ECA-MRI中的两种成像方式。两名放射科医生使用 LI-RADS v2018 诊断算法对观察结果进行评估。参考标准包括病理证实和 LI-RADS v2018 的成像标准。使用 McNemar 检验比较不同检查之间的成像特征。使用加权科恩卡帕（k）检验计算不同模式间的一致性：共纳入了 96 名患者的 144 项观察结果（平均大小为 34.0 ± 32.4 毫米）。三种成像模式对主要和辅助成像特征的检测无明显差异。考虑到所有观察结果，CT 和 EOB-MRI 之间在类别分配方面的模态间一致性很高（k 0.60；95%CI 0.44，0.75），CT 和 ECA-MRI 之间的一致性中等（k 0.46；95%CI 0.22，0.69），EOB-MRI 和 ECA-MRI 之间的一致性很高（k 0.72；95%CI 0.59，0.85）。对于小于 20 毫米的观察结果，CT 和 EOB-MRI 的模态间一致性一般（k 0.26；95%CI 0.05，0.47），CT 和 ECA-MRI 的一致性中等（k 0.42；95%CI -0.02，0.88），EOB-MRI 和 ECA-MRI 的一致性好（k 0.65；95%CI 0.47，0.82）。将 LR-5 作为 HCC 的预测指标时，ECA-MRI 表现出最高的灵敏度（70%）和特异性（100%）：结论：CT、ECA-MRI 和 EOB-MRI 三种成像模式之间的一致性在观测值小于 20 毫米时有所下降。ECA-MRI 对 HCC 诊断的灵敏度更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiologia Medica 医学-核医学

CiteScore

14.10

自引率

7.90%

发文量

133

审稿时长

4-8 weeks

期刊介绍： Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.