Study on the concordance in the diagnostic efficacy between CEUS LI-RADS and CT/MR LI-RADS for HCC

Abstract

Objective

To investigate the diagnostic concordance between CEUS LI-RADS and CT/MR LI-RADS for focal intrahepatic lesions in patients at high risk of hepatocellular carcinoma.

Methods

Retrospective analysis of imaging data of patients at high risk of HCC attending our hospital from January 2018 to January 2021, 165 lesions were classified according to CEUS LI-RADS and CT/MR LI-RADS, respectively, using puncture biopsy or surgical pathology as the criteria. The kappa concordance test was used to evaluate the classification results of intrahepatic focal lesions in high-risk groups.

Results

The concordance between CEUS and CT/MRI LI-RADS for the classification of intrahepatic focal lesions in the high-risk group of HCC was statistically different (P < 0.001), and the agreement between the two imaging methods was general (kappa = 0.345，P < 0.001). The positive predictive value of CEUS LR-5 for HCC was 95.4%, and the positive predictive value of CT/MRI LR-5 had a positive predictive value of 94.6% for HCC, and the difference between CEUS and CT/MRI LR-5 for HCC was not statistically significant. The positive predictive value of CEUS LR-M for non-HCC malignancies was 34.1%, and the positive predictive value of CT/MRI LR-M for non-HCC malignancies was 76.5%, and the difference between CEUS and CT/MRI LR-M had a statistically significant difference in the positive predictive value for non-HCC malignancies (P < 0.05).

Conclusions

The classification results of CEUS and CT/MRI LI-RADS for focal intrahepatic lesions in a high-risk group of HCC were in general agreement, but both had high diagnostic performance, and both had high specificity and positive predictive value using LR-5 as the diagnostic imaging standard for HCC, while the differential diagnostic value of LR-M for non-HCC malignant tumors and HCC still needs to be further investigated.