Jiaying Cao, Yi Dong, Xinliang Xu, Qi Zhang, Wenping Wang, Kathleen Möller, Christoph F Dietrich
{"title":"LI-RADS CEUS非放射TRA版本2024：在消融治疗的HCC患者中的应用","authors":"Jiaying Cao, Yi Dong, Xinliang Xu, Qi Zhang, Wenping Wang, Kathleen Möller, Christoph F Dietrich","doi":"10.1016/j.ultrasmedbio.2025.04.018","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of Liver Imaging Reporting and Data System (LI-RADS) contrast-enhanced ultrasound (CEUS) Nonradiation treatment response assessment (TRA) categorization v2024 for detecting viable tumors of ablated hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>Between June 2020 and December 2022, standardized CEUS data of HCC patients were prospectively collected. A retrospective analysis of LI-RADS CEUS Nonradiation TRA v2024 evaluation on HCCs was conducted by 2 independent radiologists assigning per-lesion TRA (TR-nonviable, TR-equivocal, or TR-viable) categorizations. Inter-reader agreement between the 2 readers and inter-modality agreement between LI-RADS CEUS and CT/MRI LI-RADS TRA were assessed. The diagnostic performance of imaging criteria was explored. The potential influencing factors of LI-RADS TRA categorization across modalities were further analyzed.</p><p><strong>Results: </strong>A total of 101 CEUS-LI-RADS TRA category evaluations of 88 lesions in 83 patients were included. Inter-reader agreement for the 2 readers were substantial to almost perfect (intralesional tumor viability: κ = 0.92, 95% CI: 0.76-1.0; perilesional tumor viability: κ = 0.72, 95% CI: 0.57-0.87; CEUS LR-TR: κ = 0.71, 95% CI: 0.55-0.88). Inter-modality agreements between CEUS and CT/MRI LI-RADS TRA categorizations were excellent (ICC = 0.90). CEUS LR-TRA categorization demonstrated good diagnostic performance, particularly in specificity (88.1%-100 %) and negative predictive value (NPV: 93.9%-97.9 %). Time period and abstract shape were identified as significant factors influencing reader evaluations (p < 0.05).</p><p><strong>Conclusion: </strong>LI-RADS CEUS Nonradiation TRA v2024 demonstrates fine inter-reader and inter-modality agreement, with outstanding diagnostic performance, supporting its potential for clinical application in assessing treatment response for ablated HCC.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"LI-RADS CEUS Nonradiation TRA Version 2024: Application on HCC Patients Treated With Ablation Treatment.\",\"authors\":\"Jiaying Cao, Yi Dong, Xinliang Xu, Qi Zhang, Wenping Wang, Kathleen Möller, Christoph F Dietrich\",\"doi\":\"10.1016/j.ultrasmedbio.2025.04.018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the performance of Liver Imaging Reporting and Data System (LI-RADS) contrast-enhanced ultrasound (CEUS) Nonradiation treatment response assessment (TRA) categorization v2024 for detecting viable tumors of ablated hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>Between June 2020 and December 2022, standardized CEUS data of HCC patients were prospectively collected. A retrospective analysis of LI-RADS CEUS Nonradiation TRA v2024 evaluation on HCCs was conducted by 2 independent radiologists assigning per-lesion TRA (TR-nonviable, TR-equivocal, or TR-viable) categorizations. Inter-reader agreement between the 2 readers and inter-modality agreement between LI-RADS CEUS and CT/MRI LI-RADS TRA were assessed. The diagnostic performance of imaging criteria was explored. The potential influencing factors of LI-RADS TRA categorization across modalities were further analyzed.</p><p><strong>Results: </strong>A total of 101 CEUS-LI-RADS TRA category evaluations of 88 lesions in 83 patients were included. Inter-reader agreement for the 2 readers were substantial to almost perfect (intralesional tumor viability: κ = 0.92, 95% CI: 0.76-1.0; perilesional tumor viability: κ = 0.72, 95% CI: 0.57-0.87; CEUS LR-TR: κ = 0.71, 95% CI: 0.55-0.88). Inter-modality agreements between CEUS and CT/MRI LI-RADS TRA categorizations were excellent (ICC = 0.90). CEUS LR-TRA categorization demonstrated good diagnostic performance, particularly in specificity (88.1%-100 %) and negative predictive value (NPV: 93.9%-97.9 %). Time period and abstract shape were identified as significant factors influencing reader evaluations (p < 0.05).</p><p><strong>Conclusion: </strong>LI-RADS CEUS Nonradiation TRA v2024 demonstrates fine inter-reader and inter-modality agreement, with outstanding diagnostic performance, supporting its potential for clinical application in assessing treatment response for ablated HCC.</p>\",\"PeriodicalId\":49399,\"journal\":{\"name\":\"Ultrasound in Medicine and Biology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-05-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ultrasound in Medicine and Biology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ultrasmedbio.2025.04.018\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ACOUSTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ultrasound in Medicine and Biology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ultrasmedbio.2025.04.018","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ACOUSTICS","Score":null,"Total":0}
LI-RADS CEUS Nonradiation TRA Version 2024: Application on HCC Patients Treated With Ablation Treatment.
Objective: To evaluate the performance of Liver Imaging Reporting and Data System (LI-RADS) contrast-enhanced ultrasound (CEUS) Nonradiation treatment response assessment (TRA) categorization v2024 for detecting viable tumors of ablated hepatocellular carcinoma (HCC).
Methods: Between June 2020 and December 2022, standardized CEUS data of HCC patients were prospectively collected. A retrospective analysis of LI-RADS CEUS Nonradiation TRA v2024 evaluation on HCCs was conducted by 2 independent radiologists assigning per-lesion TRA (TR-nonviable, TR-equivocal, or TR-viable) categorizations. Inter-reader agreement between the 2 readers and inter-modality agreement between LI-RADS CEUS and CT/MRI LI-RADS TRA were assessed. The diagnostic performance of imaging criteria was explored. The potential influencing factors of LI-RADS TRA categorization across modalities were further analyzed.
Results: A total of 101 CEUS-LI-RADS TRA category evaluations of 88 lesions in 83 patients were included. Inter-reader agreement for the 2 readers were substantial to almost perfect (intralesional tumor viability: κ = 0.92, 95% CI: 0.76-1.0; perilesional tumor viability: κ = 0.72, 95% CI: 0.57-0.87; CEUS LR-TR: κ = 0.71, 95% CI: 0.55-0.88). Inter-modality agreements between CEUS and CT/MRI LI-RADS TRA categorizations were excellent (ICC = 0.90). CEUS LR-TRA categorization demonstrated good diagnostic performance, particularly in specificity (88.1%-100 %) and negative predictive value (NPV: 93.9%-97.9 %). Time period and abstract shape were identified as significant factors influencing reader evaluations (p < 0.05).
Conclusion: LI-RADS CEUS Nonradiation TRA v2024 demonstrates fine inter-reader and inter-modality agreement, with outstanding diagnostic performance, supporting its potential for clinical application in assessing treatment response for ablated HCC.
期刊介绍：
Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.
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