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Liver Imaging Reporting and Data System:: Substantial Discordance Between CT and MR for Imaging Classification of Hepatic Nodules.

Abstract：

RATIONALE AND OBJECTIVES:The Liver Imaging Reporting and Data System (LI-RADS) is a newly developed nomogram for standardizing the performance and interpretation of liver imaging. However, it is unclear which imaging technique is optimal to exactly define LI-RADS scale. This study aims to determine the concordance of computed tomography (CT) and magnetic resonance imaging (MRI) for the classification of hepatic nodules (HNs) using a LI-RADS scoring system. MATERIALS AND METHODS:Major imaging features (arterial hyper-enhancement, washout, pseudo-capsule, diameter, and tumor embolus) on CT versus MRI for 118 HNs in 84 patients with diffuse liver disease were rated independently using LI-RADS by two groups of readers. Inter-reader agreement (IRA) and intraclass agreement was determined by Fleiss and Cohen's kappa (κ). Logistic regression for correlated data was used to compare diagnostic ability. RESULTS:IRA was perfect for determination of nodule size and tumor embolus (κ = 0.94-0.98). IRA was moderate to substantial for determination of arterial hyper-enhancement, washout, and pseudo-capsule (κ = 0.54-0.72). Intraclass agreement between CT and MRI was substantial for determination of washout (0.632 [95% CI: 0.494, 0.771]) and pseudo-capsule (0.670 [95% CI: 0.494, 0.847]), and fair for arterial hyper-enhancement (0.203 [95% CI: 0.051, 0.354]). CT against MR produced false-negative findings of arterial hyper-enhancement by 57.1%, washout by 21.2%, and pseudo-capsule by 42.9%; and underestimated LI-RADS score by 16.9% for LR 3, 37.3% for LR 4, and 8.5% for LR 5. CT produced significantly lower accuracy (54.3% vs 67.8%, P < 0.001) and sensitivity (31.6% vs 71.1%, P < 0.001) than MRI in the prediction of malignancy. CONCLUSIONS:There are substantial discordance between CT and MR for stratification of HNs using LI-RADS. MRI could be better than CT in optimizing the performance of LI-RADS.

journal_name

Acad Radiol

journal_title

Academic radiology

authors

Zhang YD,Zhu FP,Xu X,Wang Q,Wu CJ,Liu XS,Shi HB

doi

10.1016/j.acra.2015.11.002

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

344-52

issue

eissn

1076-6332

issn

1878-4046

pii

S1076-6332(15)00514-0

journal_volume

pub_type

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Liver Imaging Reporting and Data System:: Substantial Discordance Between CT and MR for Imaging Classification of Hepatic Nodules.