CT/MRI LI-RADS version 2018 versus CEUS LI-RADS version 2017 in the diagnosis of primary hepatic nodules in patients with high-risk hepatocellular carcinoma

Background: This study aimed to explore the application value of computed tomography/magnetic resonance imaging (CT/MRI) liver imaging reporting and data system (LI-RADS) version 2018 and contrast-enhanced ultrasound (CEUS) LI-RADS version 2017 in high-risk hepatocellular carcinoma (HCC) patients and to conduct a comparative analysis. Methods: This study enrolled 250 high-risk HCC patients with 259 primary hepatic nodules from June 2017 to June 2020. Two investigators used a single-blind method to classify all nodules. The u-test, t-test, and Kappa test were performed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value and receiver operating characteristic curves of LR-5 and LR-M in the diagnosis of HCC and non-HCC malignancy were respectively calculated. Results: CT/MRI LI-RADS v2018 and CEUS LI-RADS v2017 showed substantial agreement interobservers, and there was a moderate agreement inter-modality. The specificity and PPV of HCC and non-HCC malignancies in CT/MRI LR-5/M were higher than CEUS. The areas under the curve (AUC) of CT/MRI LR-5 and LR-M were 0.794 and 0.777, and the AUC of CEUS LR-5 and LR-M were 0.720 and 0.718, respectively. Conclusions: Two modalities have substantial agreement inter-observers and moderate agreement intermodalities. The diagnostic accuracy of HCC of CT/MRI LR-5 and non-HCC malignancy of CT/MRI LR-M are higher than CEUS.

Automated summary

This study found that computed tomography/magnetic resonance imaging (CT/MRI) and contrast-enhanced ultrasound (CEUS) have good agreement in high-risk hepatocellular carcinoma (HCC) patients, but CT/MRI demonstrated higher specificity and positive predictive value in diagnosing HCC and non-HCC malignancies.