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Diagnostic accuracy of prospective application of the Liver Imaging Reporting and Data System (LI-RADS) in gadoxetate-enhanced MRI

 Yeun-Yoon Kim  ;  Chansik An  ;  Sungwon Kim  ;  Myeong-Jin Kim 
 EUROPEAN RADIOLOGY, Vol.28(5) : 2038-2046, 2018 
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Diagnosis ; Gadolinium DTPA disodium salt ; Liver ; Magnetic resonance imaging ; Sensitivity and Specificity
OBJECTIVES: To evaluate the diagnostic performance of the LI-RADS (v2014) on gadoxetate-enhanced MRI prospectively applied in actual practice. METHODS: We retrospectively reviewed the prospectively written radiology reports of 143 treatment-naive at-risk patients who underwent gadoxetate-enhanced liver MRI from January to December 2014, and identified 202 hepatic observations categorized using the LI-RADS. The diagnostic performances of LI-RADS categories for hepatocellular carcinoma (HCC) and hepatic malignancy were calculated. RESULTS: Twenty (69.0 %) of 29 LR-4, 73 (97.3 %) of 75 LR-5, and all of five (100 %) LR-5V observations were HCCs. The remaining two (2.7 %) LR-5 observations were combined hepatocellular-cholangiocarcinomas, while 10 (76.9 %) of 13 LR-M observations were HCCs. The sensitivity and specificity of LR-5/5V for HCC were 60.5 % and 97.3 %, respectively. Including LR-M in the diagnostic criteria for HCC increased sensitivity (68.2 %, p = 0.002) but decreased specificity without statistical significance (93.2 %, p = 0.154). LR-5/5V/M yielded sensitivity of 68.9 % and specificity of 100.0 % for hepatic malignancy. CONCLUSIONS: LI-RADS v2014 was successfully applied on gadoxetate-enhanced MRI in clinical practice. LR-5/5V was the most specific diagnostic measure for HCC, but most LR-M observations were HCCs and a considerable portion of non-HCC malignancies were categorized as LR-4 or LR-5. KEY POINTS: * LR-5/5V provided a highly specific diagnosis for HCC. * Half of non-HCC malignancies were categorized as LR-4 or LR-5. * The majority of LR-M observations were finally diagnosed as HCCs. * More sensitive diagnosis of HCC was feasible with LR-5/5V/M on gadoxetate-enhanced MRI. * Observations in either LR-5/5V or LR-M categories were definitely malignant.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Sungwon(김성원) ORCID logo https://orcid.org/0000-0001-5455-6926
Kim, Yeun-Yoon(김연윤) ORCID logo https://orcid.org/0000-0003-2018-5332
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
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