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Data-Driven Modification of the LI-RADS Major Feature System on Gadoxetate Disodium-Enhanced MRI: Toward Better Sensitivity and Simplicity.

Publication ,  Journal Article
Jiang, H; Song, B; Qin, Y; Wei, Y; Konanur, M; Wu, Y; Zaki, IH; McInnes, MDF; Lafata, KJ; Bashir, MR
Published in: J Magn Reson Imaging
February 2022

BACKGROUND: The Liver Imaging Reporting and Data System (LI-RADS) is widely accepted as a reliable diagnostic scheme for hepatocellular carcinoma (HCC) in at-risk patients. However, its application is hampered by substantial complexity and suboptimal diagnostic sensitivity. PURPOSE: To propose data-driven modifications to the LI-RADS version 2018 (v2018) major feature system (rLI-RADS) on gadoxetate disodium (EOB)-enhanced magnetic resonance imaging (MRI) to improve sensitivity and simplicity while maintaining high positive predictive value (PPV) for detecting HCC. STUDY TYPE: Retrospective. POPULATION: Two hundred and twenty-four consecutive at-risk patients (training dataset: 169, independent testing dataset: 55) with 742 LR-3 to LR-5 liver observations (HCC: N = 498 [67%]) were analyzed from a prospective observational registry collected between July 2015 and September 2018. FIELD STRENGTH/SEQUENCE: 3.0 T/T2-weighted fast spin-echo, diffusion-weighted spin-echo based echo-planar and three-dimensional (3D) T1-weighted gradient echo sequences. ASSESSMENT: All images were evaluated by three independent abdominal radiologists who were blinded to all clinical, pathological, and follow-up information. Composite reference standards of either histopathology or imaging follow-up were used. STATISTICAL TESTS: In the training dataset, LI-RADS v2018 major features were used to develop rLI-RADS based on their associated PPV for HCC. In an independent testing set, diagnostic performances of LI-RADS v2018 and rLI-RADS were computed using a generalized estimating equation model and compared with McNemar's test. A P value <0.05 was considered statistically significant. RESULTS: The median (interquartile range) size of liver observations was 13 mm (7-27 mm). The diagnostic table for rLI-RADS encompassed 9 cells, as opposed to 16 cells for LI-RADS v2018. In the testing set, compared to LI-RADS v2018, rLI-RADS category 5 demonstrated a significantly superior sensitivity (76% vs. 61%) while maintaining comparably high PPV (92.5% vs. 94.1%, P = 0.126). DATA CONCLUSION: Compared with LI-RADS v2018, rLI-RADS demonstrated improved simplicity and significantly superior diagnostic sensitivity for HCC in at-risk patients. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.

Duke Scholars

Published In

J Magn Reson Imaging

DOI

EISSN

1522-2586

Publication Date

February 2022

Volume

55

Issue

2

Start / End Page

493 / 506

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Magnetic Resonance Imaging
  • Liver Neoplasms
  • Humans
  • Gadolinium DTPA
  • Contrast Media
  • Carcinoma, Hepatocellular
  • 3202 Clinical sciences
 

Citation

APA
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ICMJE
MLA
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Jiang, H., Song, B., Qin, Y., Wei, Y., Konanur, M., Wu, Y., … Bashir, M. R. (2022). Data-Driven Modification of the LI-RADS Major Feature System on Gadoxetate Disodium-Enhanced MRI: Toward Better Sensitivity and Simplicity. J Magn Reson Imaging, 55(2), 493–506. https://doi.org/10.1002/jmri.27824
Jiang, Hanyu, Bin Song, Yun Qin, Yi Wei, Meghana Konanur, Yuanan Wu, Islam H. Zaki, Matthew D. F. McInnes, Kyle J. Lafata, and Mustafa R. Bashir. “Data-Driven Modification of the LI-RADS Major Feature System on Gadoxetate Disodium-Enhanced MRI: Toward Better Sensitivity and Simplicity.J Magn Reson Imaging 55, no. 2 (February 2022): 493–506. https://doi.org/10.1002/jmri.27824.
Jiang H, Song B, Qin Y, Wei Y, Konanur M, Wu Y, et al. Data-Driven Modification of the LI-RADS Major Feature System on Gadoxetate Disodium-Enhanced MRI: Toward Better Sensitivity and Simplicity. J Magn Reson Imaging. 2022 Feb;55(2):493–506.
Jiang, Hanyu, et al. “Data-Driven Modification of the LI-RADS Major Feature System on Gadoxetate Disodium-Enhanced MRI: Toward Better Sensitivity and Simplicity.J Magn Reson Imaging, vol. 55, no. 2, Feb. 2022, pp. 493–506. Pubmed, doi:10.1002/jmri.27824.
Jiang H, Song B, Qin Y, Wei Y, Konanur M, Wu Y, Zaki IH, McInnes MDF, Lafata KJ, Bashir MR. Data-Driven Modification of the LI-RADS Major Feature System on Gadoxetate Disodium-Enhanced MRI: Toward Better Sensitivity and Simplicity. J Magn Reson Imaging. 2022 Feb;55(2):493–506.
Journal cover image

Published In

J Magn Reson Imaging

DOI

EISSN

1522-2586

Publication Date

February 2022

Volume

55

Issue

2

Start / End Page

493 / 506

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Magnetic Resonance Imaging
  • Liver Neoplasms
  • Humans
  • Gadolinium DTPA
  • Contrast Media
  • Carcinoma, Hepatocellular
  • 3202 Clinical sciences