Application of DCE-US using the LI-RADS for patients with liver nodules at high risk for hepatocellular carcinoma: A preliminary study and comparison with visual interpretation. Issue 155 (October 2022)

• Record Type: Journal Article
• Authors: Qiu, Shibo; Ding, Jianmin; Qin, Zhengyi; Zhou, Yan; Zhou, Hongyu; Wang, Yandong; Zhao, Lei; Jing, Xiang
• Is Part Of: European journal of radiology. Issue 155(2022)
• Publication Date: 2022-10
• Subjects: Hepatocellular carcinoma -- Liver imaging reporting and data system -- Ultrasound -- Dynamic contrast-enhanced ultrasound (DCE-US); Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110473
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Objective: To explore the value of dynamic contrast-enhanced ultrasound (DCE-US) for the Liver Imaging Reporting and Data System (LI-RADS). Methods: We included 220 liver nodules at high risk for hepatocellular carcinoma (HCC) from January 2019 to October 2021. Visual interpretation and DCE-US-based quantitative categories using VueBox® software were compared for consistency, nodule enhancement intensity, and washout onset following the contrast-enhanced ultrasound LI-RADS. Taking the cut-off value of the ROC curve on washout onset as the time criterion of early washout of LR-M nodules, analyzed the diagnostic performance of LR-5 for HCC and compared it to that of washout onset within 60 s. Results: The LI-RADS visual and DCE-US interpretation results showed good consistency (Kappa = 0.730), but differed significantly in determining the LR-5 washout onset (91.2 ± 30.2 vs. 82.0 ± 32.8 s, P = 0.020) and detecting early washout (<60 s) in 196 nodules ( P = 0.047). Distinguishing HCC from non-HCC malignancies had: area under the ROC curve, 0.85 (95 % confidence interval, 0.8–0.9); Youden index, 0.69; cut-off value, 48 s; sensitivity, 74.4 %; specificity, 95.0 %. When LR-M diagnosis used washout onset within 48 s, LR-5 diagnosis had sensitivity, 72.8 %; specificity, 95.0 %; positive predictive value, 98.5 %; showing a higher sensitivity than with washout onset in 60 s (62.2 %; P = 0.033). Conclusion: DCE-US and visual interpretations showed high consistency in LI-RADS categories but differed in assessing the washout time. According to the DCE-US interpretation, the diagnostic performance of LR-5 could be improved using washout onset of 48 s for LR-M.