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Diagnostic performance of the LR-M criteria and spectrum of LI-RADS imaging features among primary hepatic carcinomas

 Seung-Seob Kim  ;  Sunyoung Lee  ;  Jin-Young Choi  ;  Joon Seok Lim  ;  Mi-Suk Park  ;  Myeong-Jin Kim 
 ABDOMINAL RADIOLOGY, Vol.45(11) : 3743-3754, 2020-11 
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Carcinoma ; Cholangiocarcinoma ; Diagnosis ; Differential ; Hepatocellular ; Liver neoplasms ; Magnetic resonance imaging
Purpose: To evaluate the diagnostic performance of LR-M criteria for differentiating hepatocellular carcinoma, intrahepatic mass-forming cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma and to compare the imaging features of each type.

Methods: In this retrospective study, 110 patients were surgically diagnosed with cholangiocarcinoma (n = 67) and combined hepatocellular-cholangiocarcinoma (n = 43) at a single tertiary hospital between 2013 and 2018. Among them, those with risk factors were enrolled (16 cholangiocarcinomas and 33 combined hepatocellular-cholangiocarcinomas). Forty-nine other patients with size-matched hepatocellular carcinoma were selected as a control group. Two independent readers evaluated the imaging findings of the preoperative MRIs based on LI-RADS version 2018 and assigned an LI-RADS category. The diagnostic performance of the LR-M criteria for diagnosing cholangiocarcinoma or combined hepatocellular-cholangiocarcinoma was evaluated, and the imaging features were compared. The imaging findings of the tumors in patients without risk factors (51 cholangiocarcinomas and 10 combined hepatocellular-cholangiocarcinomas) were evaluated for subgroup analysis.

Results: In the non-hepatocellular carcinoma group, 33 patients were categorized into LR-M and 14 patients into LR-5 (67.3% and 28.6%, respectively), while 5 patients with hepatocellular carcinoma were categorized into LR-M and 38 patients into LR-5 (10.2% and 77.6%, respectively). Sensitivity and specificity of the LR-M criteria were 67.3% and 89.8%, respectively. When more than two LR-M features were present, cholangiocarcinoma or combined hepatocellular-cholangiocarcinoma were suggested with a specificity of 95.9%.

Conclusion: The diagnostic performance of the LR-M criteria is acceptable with moderate sensitivity and high specificity for both cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma. Imaging findings of primary hepatic carcinomas should be understood as a spectrum.
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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, Seung-seob(김승섭) ORCID logo https://orcid.org/0000-0001-6071-306X
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Lee, Sunyoung(이선영) ORCID logo https://orcid.org/0000-0002-6893-3136
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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