Francesco Agnello, Roberto Cannella, Giuseppe Brancatelli, Massimo Galia
{"title":"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。","authors":"Francesco Agnello, Roberto Cannella, Giuseppe Brancatelli, Massimo Galia","doi":"10.1007/s11547-024-01879-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":"1575-1586"},"PeriodicalIF":9.7000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"LI-RADS v2018 category and imaging features: inter-modality agreement between contrast-enhanced CT, gadoxetate disodium-enhanced MRI, and extracellular contrast-enhanced MRI.\",\"authors\":\"Francesco Agnello, Roberto Cannella, Giuseppe Brancatelli, Massimo Galia\",\"doi\":\"10.1007/s11547-024-01879-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":20817,\"journal\":{\"name\":\"Radiologia Medica\",\"volume\":\" \",\"pages\":\"1575-1586\"},\"PeriodicalIF\":9.7000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiologia Medica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11547-024-01879-8\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiologia Medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11547-024-01879-8","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/19 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
LI-RADS v2018 category and imaging features: inter-modality agreement between contrast-enhanced CT, gadoxetate disodium-enhanced MRI, and extracellular contrast-enhanced MRI.
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.
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.
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