Cited 67 times in
Interobserver Variability and Diagnostic Performance of Gadoxetic Acid-enhanced MRI for Predicting Microvascular Invasion in Hepatocellular Carcinoma
DC Field | Value | Language |
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dc.date.accessioned | 2022-09-01T01:18:13Z | - |
dc.date.available | 2022-09-01T01:18:13Z | - |
dc.date.issued | 2020-12 | - |
dc.identifier.issn | 0033-8419 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/189896 | - |
dc.description.abstract | Background: Accurate identification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) before treatment is critical for selecting a proper treatment strategy. Purpose: To evaluate the interobserver agreement and the diagnostic performance of the MRI assessment of MVI in HCC according to the level of radiologist experience. Materials and Methods: This retrospective study included 100 patients with surgically confirmed HCCs smaller than 5 cm who underwent gadoxetic acid-enhanced MRI between 2013 and 2016. Eight postfellowship radiologists (four with 7-13 years of experience [more experienced] and four with 3-6 years of experience [less experienced]) evaluated four imaging features (nonsmooth tumor margin, irregular rim-like enhancement in the arterial phase, peritumoral arterial phase hyperenhancement, peritumoral hepatobiliary phase hypointensity) and assigned the possibility of MVI. Interobserver agreement was determined by using Fleiss k statistics according to reviewer experience and tumor size (<= 3 cm vs >3 cm). With reference standards of histopathologic specimens, the diagnostic performance in the identification of MVI was assessed by using receiver operating characteristic curve analysis. Results: In 100 patients (mean age, 58 years +/- 10 [standard deviation]; 70 men) with 100 HCCs (mean size, 2.8 cm +/- 0.9), 39 (39%) HCCs had MVI. The overall interobserver agreement was fair to moderate for the imaging features and their combinations (k = 0.38-0.47) and MVI probability (k = 0.41; 95% confidence interval: 0.33, 0.45). More experienced reviewers demonstrated higher agreement in MVI probability than less experienced reviewers (k = 0.55 vs 0.36, respectively; P = .002). Diagnostic performance of each reviewer was modest for MVI prediction (area under the receiver operating characteristic curve [AUC] range, 0.60-0.74). The AUCs for the diagnosis of MVI were lower for HCCs larger than 3 cm (range, 0.55-0.69) than for those less than or equal to 3 cm (range, 0.59-0.75). Conclusion: Considerable interobserver variability exists in the assessment of microvascular invasion in hepatocellular carcinoma using MRI, even for more experienced radiologists. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Radiological Society of North America | - |
dc.relation.isPartOf | RADIOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Carcinoma, Hepatocellular / pathology* | - |
dc.subject.MESH | Clinical Competence* | - |
dc.subject.MESH | Contrast Media | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Gadolinium DTPA | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Liver Neoplasms / pathology* | - |
dc.subject.MESH | Magnetic Resonance Imaging / methods* | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Neoplasm Invasiveness / pathology* | - |
dc.subject.MESH | Observer Variation | - |
dc.subject.MESH | Predictive Value of Tests | - |
dc.subject.MESH | Retrospective Studies | - |
dc.title | Interobserver Variability and Diagnostic Performance of Gadoxetic Acid-enhanced MRI for Predicting Microvascular Invasion in Hepatocellular Carcinoma | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Radiology (영상의학교실) | - |
dc.contributor.googleauthor | Ji Hye Min | - |
dc.contributor.googleauthor | Min Woo Lee | - |
dc.contributor.googleauthor | Hee Sun Park | - |
dc.contributor.googleauthor | Dong Ho Lee | - |
dc.contributor.googleauthor | Hyun Jeong Park | - |
dc.contributor.googleauthor | Sanghyeok Lim | - |
dc.contributor.googleauthor | Seo-Youn Choi | - |
dc.contributor.googleauthor | Jisun Lee | - |
dc.contributor.googleauthor | Ji Eun Lee | - |
dc.contributor.googleauthor | Sang Yun Ha | - |
dc.contributor.googleauthor | Dong Ik Cha | - |
dc.contributor.googleauthor | Keumhee Chough Carriere | - |
dc.contributor.googleauthor | Joong Hyun Ahn | - |
dc.identifier.doi | 10.1148/radiol.2020201940 | - |
dc.relation.journalcode | J02596 | - |
dc.identifier.eissn | 1527-1315 | - |
dc.identifier.pmid | 32990512 | - |
dc.identifier.url | https://pubs.rsna.org/doi/10.1148/radiol.2020201940 | - |
dc.citation.volume | 297 | - |
dc.citation.number | 3 | - |
dc.citation.startPage | 573 | - |
dc.citation.endPage | 581 | - |
dc.identifier.bibliographicCitation | RADIOLOGY, Vol.297(3) : 573-581, 2020-12 | - |
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