Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Impact of the Liver Imaging Reporting and Data System on Research Studies of Diagnosing Hepatocellular Carcinoma Using MRI

  • Yura Ahn (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Sang Hyun Choi (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jong Keon Jang (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • So Yeon Kim (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Ju Hyun Shim (Department of Gastroenterology, Liver Center, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Seung Soo Lee (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Jae Ho Byun (Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center)
  • Received : 2021.02.12
  • Accepted : 2021.12.08
  • Published : 2022.05.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: Since its introduction in 2011, the CT/MRI diagnostic Liver Imaging Reporting and Data System (LI-RADS) has been updated in 2014, 2017, and 2018. We evaluated the impact of CT/MRI diagnostic LI-RADS on liver MRI research methodology for the diagnosis of hepatocellular carcinoma (HCC). Materials and Methods: The MEDLINE, EMBASE, and Cochrane databases were searched for original articles reporting the diagnostic performance of liver MRI for HCC between 2011 and 2019. The MRI techniques, image analysis methods, and diagnostic criteria for HCC used in each study were investigated. The studies were classified into three groups according to the year of publication (2011-2013, 2014-2016, and 2017-2019). We compared the percentage of studies adopting MRI techniques recommended by LI-RADS, image analysis methods in accordance with the lexicon defined in LI-RADS, and diagnostic criteria endorsed by LI-RADS. We compared the pooled sensitivity and specificity between studies that used the LI-RADS and those that did not. Results: This systematic review included 179 studies. The percentages of studies using imaging techniques recommended by LI-RADS were 77.8% for 2011-2013, 85.7% for 2014-2016, and 84.2% for 2017-2019, with no significant difference (p = 0.951). After the introduction of LI-RADS, the percentages of studies following the LI-RADS lexicon were 0.0%, 18.4%, and 56.6% in the respective periods (p < 0.001), while the percentages of studies using the LI-RADS diagnostic imaging criteria were 0.0%, 22.9%, and 60.7%, respectively (p < 0.001). Studies that did not use the LI-RADS and those that used the LIRADS version 2018 showed no significant difference in sensitivity and specificity (86.3% vs. 77.7%, p = 0.102 and 91.4% vs. 89.9%, p = 0.770, respectively), with some difference in heterogeneity (I2 = 94.3% vs. 86.7% in sensitivity and I2 = 86.6% vs. 53.2% in specificity). Conclusion: LI-RADS imparted significant changes in the image analysis methods and diagnostic criteria used in liver MRI research for the diagnosis of HCC.

Keywords

Acknowledgement

SH Choi received a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (grant number: NRF-2019R1G1A1099743). The other authors have no conflicts of interest to declare.

References

  1. El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 2007;132:2557-2576
  2. Mitchell DG, Bruix J, Sherman M, Sirlin CB. LI-RADS (liver imaging reporting and data system): summary, discussion, and consensus of the LI-RADS management working group and future directions. Hepatology 2015;61:1056-1065
  3. Chernyak V, Sirlin CB. Editorial for "interreader agreement of liver imaging reporting and data system on MRI: a systematic review and meta analysis". J Magn Reson Imaging 2020;52:805-806
  4. American College of Radiology. CT/MRI LI-RADS v2014 flash cards. ACR.org Web site. https://www.acr.org/-/media/ACR/Files/Clinical-Resources/LIRADS/LI-RADS-2014-Flash-Cards.pdf. Accessed November 21, 2021
  5. American College of Radiology. CT/MRI LI-RADS® v2017 core. ACR.org Web site. https://www.acr.org/-/media/ACR/Files/RADS/LI-RADS/LIRADS_2017_Core.pdf. Accessed November 21, 2021
  6. American College of Radiology. CT/MRI LI-RADS® v2018 core. ACR.org Web site. https://www.acr.org/-/media/ACR/ Files/RADS/LI-RADS/LI-RADS-2018-Core.pdf?la=en. Accessed November 21, 2021
  7. Elsayes KM, Hooker JC, Agrons MM, Kielar AZ, Tang A, Fowler KJ, et al. 2017 version of LI-RADS for CT and MR imaging: an update. Radiographics 2017;37:1994-2017
  8. Fowler KJ, Tang A, Santillan C, Bhargavan-Chatfield M, Heiken J, Jha RC, et al. Interreader reliability of LI-RADS version 2014 algorithm and imaging features for diagnosis of hepatocellular carcinoma: a large international multireader study. Radiology 2018;286:173-185
  9. Kang JH, Choi SH, Lee JS, Park SH, Kim KW, Kim SY, et al. Interreader agreement of liver imaging reporting and data system on MRI: a systematic review and meta-analysis. J Magn Reson Imaging 2020;52:795-804
  10. Kim DH, Choi SH, Park SH, Kim KW, Byun JH, Kim SY, et al. Meta-analysis of the accuracy of liver imaging reporting and data system category 4 or 5 for diagnosing hepatocellular carcinoma. Gut 2019;68:1719-1721
  11. van der Pol CB, Lim CS, Sirlin CB, McGrath TA, Salameh JP, Bashir MR, et al. Accuracy of the liver imaging reporting and data system in computed tomography and magnetic resonance image analysis of hepatocellular carcinoma or overall malignancy-a systematic review. Gastroenterology 2019;156:976-986
  12. Corwin MT, Fananapazir G, Jin M, Lamba R, Bashir MR. Differences in liver imaging and reporting data system categorization between MRI and CT. AJR Am J Roentgenol 2016;206:307-312
  13. McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. JAMA 2018;319:388-396
  14. Maubon AJ, Ferru JM, Berger V, Soulage MC, DeGraef M, Aubas P, et al. Effect of field strength on MR images: comparison of the same subject at 0.5, 1.0, and 1.5 T. Radiographics 1999;19:1057-1067
  15. Byun J, Choi SH, Byun JH, Lee SJ, Kim SY, Won HJ, et al. Comparison of the diagnostic performance of imaging criteria for HCCs ≤ 3.0 cm on gadoxetate disodium-enhanced MRI. Hepatol Int 2020;14:534-543
  16. Lee S, Kim SS, Chang DR, Kim H, Kim MJ. Comparison of LIRADS 2018 and KLCA-NCC 2018 for noninvasive diagnosis of hepatocellular carcinoma using magnetic resonance imaging. Clin Mol Hepatol 2020;26:340-351