scholarly journals American College of Radiology Contrast Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for the diagnosis of Hepatocellular Carcinoma: a pictorial essay

2017 ◽  
Vol 38 (03) ◽  
pp. 320-324 ◽  
Author(s):  
Fabio Piscaglia ◽  
Stephanie Wilson ◽  
Andrej Lyshchik ◽  
David Cosgrove ◽  
Christoph Dietrich ◽  
...  
Author(s):  
Hang Zhou ◽  
Chao Zhang ◽  
Linyao Du ◽  
Jiapeng Jiang ◽  
Qing Zhao ◽  
...  

Abstract Objectives To determine the diagnostic performance and inter-reader agreement of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS-LI-RADS) for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. Methods In this prospective study, CEUS-LI-RADS categories (LR-5 for predicting HCC) were assigned by six blinded readers and compared to the definitive HCC diagnosis in patients with liver cirrhosis per the 2017 China Liver Cancer Guidelines (CLCG). CEUS features were recorded in 96 patients with 96 histology-proven lesions. The diagnostic performance of LR-5 was described by the sensitivity, specificity and accuracy. Multi-reader agreement was assessed by using intraclass correlation coefficients (ICC). Results In cirrhotic patients, the specificity of LR-5 (range: 92.7–100.0 %) was statistically higher than that of CLCG for each reader (range: 28.6–64.3 %). However, the sensitivity (range: 38.6–63.6 %) and accuracy (range: 53.4–70.7 %) were statistically lower in CEUS-LIRADS than in CLCG (sensitivity range: 88.6–100.0 %; accuracy range: 77.6–86.2 %). Only fair to moderate inter-reader agreement was achieved for the CEUS-LI-RADS category (ICC = 0.595) and washout appearance (ICC range: 0.338 to 0.555). Neither nodule-in-nodule nor mosaic architecture was observed more often in HCC (all P > 0.05), with poor inter-reader consistency for both (both ICC < 0.20). Conclusion CEUS-LI-RADS category 5 has a high specificity but a low accuracy for identifying HCC in high-risk patients. Inter-reader agreement is not satisfactory concerning CEUS-LIRADS category and washout appearance. Moreover, the clinical value of ancillary features favoring HCC is quite limited.


2020 ◽  
Vol 40 (10) ◽  
pp. 2345-2352
Author(s):  
Jaeseung Shin ◽  
Sunyoung Lee ◽  
Heejin Bae ◽  
Yong Eun Chung ◽  
Jin‑Young Choi ◽  
...  

2021 ◽  
Vol 94 (1126) ◽  
pp. 20201359
Author(s):  
Jia-Min Pan ◽  
Wei Chen ◽  
Yan-Ling Zheng ◽  
Mei-Qing Cheng ◽  
Dan Zeng ◽  
...  

Objectives: To validate the efficacy of contrast-enhanced ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) and its major features in diagnosing hepatocellular carcinoma (HCC) of different sizes in high-risk patients. Methods: Between January 2014 and December 2015, a total of 545 untreated liver nodules were included. These liver nodules were divided into two groups (<20 mm and ≥20 mm). Each nodule was classified based on CEUS LI-RADS. The diagnostic performance comparison was assessed by the chi-square test, with pathology results as the golden criterion. Results: The accuracy, sensitivity, specificity, and positive predictive value (PPV) of CEUS LR-5 criteria in <20 mm group vs ≥20 mm group in diagnosing HCC were 60.5% vs 59.8%, 55.6% vs 57.6%, 85.7% vs 88.6 and 95.2% vs 98.5%, respectively, without significant difference (all p > 0.05). The accuracy, sensitivity and PPV of LR5/M for malignancy in <20 mm group were lower than in ≥20 mm group, with values of 79.1% vs 95.0%, 84.2% vs 95.7 and 91.4% vs 99.2%, respectively (p < 0.05). Conclusions: The CEUS LI-RADS has a comparable performance for diagnosing HCC between lesions ≥ 20 mm and <20 mm. For diagnosing malignancy including HCC, it has a higher efficacy for lesions ≥ 20 mm than <20 mm. Advances in knowledge: 1.For diagnosing HCC, CEUS LI-RADS has comparable performances between lesions ≥ 20 mm and <20 mm. 2. For diagnosing malignancy including HCC, CEUS LI-RADS has a higher efficacy for lesions ≥ 20 mm than <20 mm.


2021 ◽  
Author(s):  
HuiFang Li ◽  
Wei Huang ◽  
Wei Zheng ◽  
Qing Li ◽  
YunZhu Dai ◽  
...  

Abstract Background: Contrast-enhanced Ultrasonography Liver Imaging Reporting and Data System (CEUS LI-RADS) released by American College of Radiology was a widely used reporting system for patients at risk with hepatocellular carcinoma (HCC). In CEUS LI-RADS, the categories range from definitely benign (LR-1), probably begin (LR-2), intermediate probability of malignancy (LR-3), probably HCC (LR-4) to definitely HCC (LR-5), malignancy (LR-M), or definite tumor in vein (LR-TIV). Methods: We searched MEDLINE, Web of Science, Cochrane, Embase, and Chinese databases to obtain eligible studies reporting on the diagnostic performance of CEUS LI-RADS in patients at risk for HCC. Results: Twelve studies were eligible in the analysis, including 5275 patients, 5739 observations, and 4066 HCCs. The pooled sensitivity and specificity were 70% (95% Confidence Interval [CI] 65%-74%), 94% (95% CI, 91%-96%) of LR-5 category as predictors of HCC, respectively. The pooled sensitivity and specificity of LR-M category as a predictor of non-HCC malignancy were 83% (95% CI, 71%-91%), 94% (95% CI 88%-97%), respectively. The pooled proportions of HCCs were 1% (95% CI 0%-6%) for LR-2, 20% (95% CI, 9%-34%) for LR-3, 78% (95% CI, 67%-88%) for LR-4, 97% (95% CI, 94%-99%) for LR-5, 40% (95% CI, 23%–58%) for LR-M and 100% (95% CI, 93%–100%) for LR-TIV.Conclusion: CEUS LI-RADS is an important tool for the diagnosis of HCC.


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