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Diagnostic performance of Liver Imaging Reporting and Data System in patients at risk of both hepatocellular carcinoma and metastasis

 Min Jeong Cho  ;  Chansik An  ;  Khalid Suliman Aljoqiman  ;  Jin-Young Choi  ;  Joon Seok Lim  ;  Mi-Suk Park  ;  Hyungjin Rhee  ;  Myeong-Jin Kim 
 ABDOMINAL RADIOLOGY, Vol.45(11) : 3789-3799, 2020-11 
Journal Title
Issue Date
Contrast media ; Database management systems ; Differential diagnosis ; Liver cirrhosis ; Liver neoplasms ; Magnetic resonance imaging
Objective: The purpose of this study was to evaluate the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS) in patients with both chronic liver disease and a history of extrahepatic malignancy.

Materials and methods: This retrospective study included 59 hepatocellular carcinomas (HCCs) and 45 metastases pathologically confirmed between 2008 and 2017 in 104 patients with chronic liver disease (cirrhosis or chronic hepatitis B) and a history of extrahepatic malignancy. Two radiologists blinded to the final diagnosis independently reviewed MRI (95 patients) or CT (9 patients) images, and their consensus data were used to calculate the diagnostic performance of LI-RADS categories. Serum tumor markers, tumor multiplicity, and suspected metastatic lymph nodes were also evaluated.

Results: The sensitivity, specificity, and accuracy of LR-5 for diagnosing HCC were 69% (95% confidence intervals [CI] 56-81), 98% (95% CI 88-99), and 82% (95% CI 73-89), respectively, and those of LR-M for diagnosing metastasis were 89% (95% CI 76-96), 88% (95% CI 77-95), and 88% (95% CI 81-94), respectively. Elevation of serum carcinoembryonic antigen (P = 0.01) or carbohydrate antigen 19-9 levels (P = 0.02) and tumor multiplicity (P = 0.004) were more frequently observed in metastasis than in HCC. Three of four metastases categorized as LR-4 or LR-5 were smaller than 2 cm.

Conclusions: The LI-RADS provides high specificity (98%) for differentiating HCC from metastases in patients with both chronic liver disease and a history of extrahepatic malignancy.
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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
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
Rhee, Hyungjin(이형진) ORCID logo https://orcid.org/0000-0001-7759-4458
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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