TY - JOUR
T1 - Comparison of the diagnostic performance of imaging criteria for HCCs ≤ 3.0 cm on gadoxetate disodium-enhanced MRI
AU - Byun, Jieun
AU - Choi, Sang Hyun
AU - Byun, Jae Ho
AU - Lee, So Jung
AU - Kim, So Yeon
AU - Won, Hyung Jin
AU - Shin, Yong Moon
AU - Kim, Pyo Nyun
N1 - Publisher Copyright:
© 2020, Asian Pacific Association for the Study of the Liver.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background and purpose: Imaging-based diagnostic systems play important roles in hepatocellular carcinoma (HCC). We aimed to compare the diagnostic performance of recently updated imaging criteria for HCCs ≤ 3.0 cm on gadoxetate disodium-enhanced magnetic resonance imaging (MRI). Methods: 493 nodules (399 HCCs, 24 other malignancies, 70 benign) 1.0–3.0 cm from 400 patients, including 322 male (mean age 59.3 ± 9.4 years) and 78 female (mean age 61.2 ± 9.0 years), at risk for HCC who underwent gadoxetate disodium-enhanced MRI between July 2015 and December 2016 were retrospectively evaluated. Final diagnosis was determined histopathologically or clinically. The sensitivity and specificity in diagnosing HCC of the latest versions of four imaging criteria [Liver Imaging Reporting and Data System (LI-RADS), European Association for the Study of the Liver (EASL), Asian Pacific Association for the Study of the Liver (APASL), Korean Liver Cancer Association-National Cancer Center (KLCA-NCC)] were compared using generalized estimating equations. Results: In 331 only pathologically diagnosed nodules, the sensitivities of both the APASL (86.8%) and KLCA-NCC criteria (85.4%) were significantly higher than the sensitivities of the EASL (71.8%) and LR-5 (71.1%) criteria (p < 0.001 for each pairwise comparison). However, the specificity of LR-5 was significantly higher than that of APASL (92.2% vs. 70.6%, respectively; p = 0.011) but did not differ significantly from the specificities of EASL (84.3%; p = 0.634) and KLCA-NCC (78.4%; p = 0.107). Conclusion: Of the four international imaging criteria, LI-RADS and EASL showed high specificity but suboptimal sensitivity for diagnosing HCCs ≤ 3 cm. However, APASL and KLCA-NCC had a higher sensitivity but a lower specificity than LI-RADS and EASL.
AB - Background and purpose: Imaging-based diagnostic systems play important roles in hepatocellular carcinoma (HCC). We aimed to compare the diagnostic performance of recently updated imaging criteria for HCCs ≤ 3.0 cm on gadoxetate disodium-enhanced magnetic resonance imaging (MRI). Methods: 493 nodules (399 HCCs, 24 other malignancies, 70 benign) 1.0–3.0 cm from 400 patients, including 322 male (mean age 59.3 ± 9.4 years) and 78 female (mean age 61.2 ± 9.0 years), at risk for HCC who underwent gadoxetate disodium-enhanced MRI between July 2015 and December 2016 were retrospectively evaluated. Final diagnosis was determined histopathologically or clinically. The sensitivity and specificity in diagnosing HCC of the latest versions of four imaging criteria [Liver Imaging Reporting and Data System (LI-RADS), European Association for the Study of the Liver (EASL), Asian Pacific Association for the Study of the Liver (APASL), Korean Liver Cancer Association-National Cancer Center (KLCA-NCC)] were compared using generalized estimating equations. Results: In 331 only pathologically diagnosed nodules, the sensitivities of both the APASL (86.8%) and KLCA-NCC criteria (85.4%) were significantly higher than the sensitivities of the EASL (71.8%) and LR-5 (71.1%) criteria (p < 0.001 for each pairwise comparison). However, the specificity of LR-5 was significantly higher than that of APASL (92.2% vs. 70.6%, respectively; p = 0.011) but did not differ significantly from the specificities of EASL (84.3%; p = 0.634) and KLCA-NCC (78.4%; p = 0.107). Conclusion: Of the four international imaging criteria, LI-RADS and EASL showed high specificity but suboptimal sensitivity for diagnosing HCCs ≤ 3 cm. However, APASL and KLCA-NCC had a higher sensitivity but a lower specificity than LI-RADS and EASL.
KW - Asian Pacific Association for the Study of the Liver
KW - Carcinoma, Hepatocellular
KW - Diagnostic algorithm
KW - Diagnostic imaging
KW - Diagnostic performance
KW - European Association for the Study of the Liver
KW - Korean Liver Cancer Association-National Cancer Center
KW - Liver
KW - Liver Imaging Reporting and Data System
KW - Magnetic resonance imaging
UR - http://www.scopus.com/inward/record.url?scp=85084054263&partnerID=8YFLogxK
U2 - 10.1007/s12072-020-10040-2
DO - 10.1007/s12072-020-10040-2
M3 - Article
C2 - 32314171
AN - SCOPUS:85084054263
SN - 1936-0533
VL - 14
SP - 534
EP - 543
JO - Hepatology International
JF - Hepatology International
IS - 4
ER -