Is concurrent LR-5 associated with a higher rate of hepatocellular carcinoma in LR-3 or LR-4 observations? An individual participant data meta-analysis

被引：4

作者：

Abedrabbo, Nicole ^{[1
]}

Lerner, Emily ^{[1
]}

Lam, Eric ^{[2
]}

Kadi, Diana ^{[1
]}

Dawit, Haben ^{[3
]}

van der Pol, Christian ^{[4
,5
]}

Salameh, Jean-Paul ^{[2
]}

Naringrekar, Haresh ^{[6
]}

Adamo, Robert ^{[7
]}

Alabousi, Mostafa ^{[8
]}

Levis, Brooke ^{[9
]}

Tang, An ^{[10
]}

Alhasan, Ayman ^{[11
]}

Arvind, Ashwini ^{[12
]}

Singal, Amit ^{[13
]}

Allen, Brian ^{[1
]}

Bartnik, Krzysztof ^{[14
]}

Podgorska, Joanna ^{[14
]}

Furlan, Alessandro ^{[15
]}

Cannella, Roberto ^{[16
]}

Dioguardi Burgio, Marco ^{[17
]}

Cerny, Milena ^{[10
]}

Choi, Sang Hyun ^{[18
]}

Clarke, Christopher ^{[19
]}

Jing, Xiang ^{[20
]}

Kierans, Andrea ^{[21
]}

Ronot, Maxime ^{[17
]}

Rosiak, Grzegorz ^{[14
]}

Jiang, Hanyu

Song, Ji Soo ^{[22
]}

Reiner, Caecilia C. ^{[23
]}

Joo, Ijin ^{[24
]}

Kwon, Heejin ^{[25
]}

Wang, Wentao ^{[26
]}

Rao, Sheng-xiang ^{[26
]}

Diaz Telli, Federico ^{[27
]}

Pinero, Federico ^{[28
]}

Seo, Nieun ^{[29
]}

Kang, Hyo-Jin ^{[24
]}

Wang, Jin ^{[30
]}

Min, Ji Hye ^{[31
]}

Costa, Andreu ^{[32
]}

Mcinnes, Matthew ^{[2
]}

Bashir, Mustafa ^{[1
]}

机构：

[1] Duke Univ, Sch Med, Durham, NC 27708 USA

[2] Ottawa Hosp Res Inst, Ottawa, ON, Canada

[3] Univ Toronto, Toronto, ON, Canada

[4] McMaster Univ, Juravinski Hosp, Hamilton Hlth Sci, Hamilton, ON, Canada

[5] McMaster Univ, Canc Ctr, Hamilton Hlth Sci, Hamilton, ON, Canada

[6] Thomas Jefferson Univ, Philadelphia, PA USA

[7] Univ Ottawa, Ottawa, ON, Canada

[8] McMaster Univ, Hamilton, ON, Canada

[9] Jewish Gen Hosp, Montreal, PQ, Canada

[10] Univ Montreal, Montreal, PQ, Canada

[11] Taibah Univ, Medina, Saudi Arabia

[12] Univ Texas Southwestern Med Ctr, Dallas, TX USA

[13] Univ Texas Southwestern Med Ctr, Dept Internal Med, Div Digest & Liver Dis, Dallas, TX USA

[14] Med Univ Warsaw, Warsaw, Poland

[15] Univ Pittsburgh, Pittsburgh, PA USA

[16] Univ Palermo, Dept Biomed Neurosci & Adv Diagnost BiND, Sect Radiol, Palermo, Italy

[17] Univ Paris Cite, Paris, France

[18] Univ Ulsan, Ulsan, South Korea

[19] Nottingham Univ Hosp NHS Trust, Nottingham, England

[20] Tianjin Third Cent Hosp, Tianjin, Peoples R China

[21] Weill Cornell Med Ctr, New York, NY USA

[22] Jeonbuk Natl Univ, Med Sch & Hosp, Jeonju, South Korea

[23] Univ Hosp Zurich, Zurich, Switzerland

[24] Seoul Natl Univ Hosp, Seoul, South Korea

[25] Dong A Univ Hosp, Pusan, South Korea

[26] Fudan Univ, Zhongshan Hosp, Shanghai, Peoples R China

[27] Hosp Univ Austral, Dept Phamacy, Buenos Aires, Argentina

[28] Univ Austral, Hepatol & Liver Transplant Unit, Buenos Aires, Argentina

[29] Yonsei Univ Hlth Syst, Seoul, South Korea

[30] Sun Yat Sen Univ, Guangzhou, Peoples R China

[31] Sungkyunkwan Univ, Sch Med, Ctr Imaging Sci, Sch Med, Seoul, South Korea

[32] Queen Elizabeth 2 Hlth Sci Ctr, Halifax, NS, Canada

来源：

ABDOMINAL RADIOLOGY | 2025年 / 50卷 / 04期

关键词：

LI-RADS; Hepatocellular carcinoma; Concurrent; LR-3; LR-4; Positive predictive value; LI-RADS; MAJOR FEATURES; MRI; RISK; CATEGORIZATION; DIAGNOSIS; ACCURACY; CRITERIA;

D O I：

10.1007/s00261-024-04580-6

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

BackgroundThe Liver Imaging Reporting and Data System (LI-RADS) does not consider factors extrinsic to the observation of interest, such as concurrent LR-5 observations.PurposeTo evaluate whether the presence of a concurrent LR-5 observation is associated with a difference in the probability that LR-3 or LR-4 observations represent hepatocellular carcinoma (HCC) through an individual participant data (IPD) meta-analysis.MethodsMultiple databases were searched from 1/2014 to 2/2023 for studies evaluating the diagnostic accuracy of CT/MRI for HCC using LI-RADS v2014/2017/2018. The search strategy, study selection, and data collection process can be found at https://osf.io/rpg8x. Using a generalized linear mixed model (GLMM), IPD were pooled across studies and modeled simultaneously with a one-stage meta-analysis approach to estimate positive predictive value (PPV) of LR-3 and LR-4 observations without and with concurrent LR-5 for the diagnosis of HCC. Risk of bias was assessed using a composite reference standard and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2).ResultsTwenty-nine studies comprising 2591 observations in 1456 patients (mean age 59 years, 1083 [74%] male) were included. 587/1960 (29.9%) LR-3 observations in 1009 patients had concurrent LR-5. The PPV for LR-3 observations with concurrent LR-5 was not significantly different from the PPV without LR-5 (45.4% vs 37.1%, p = 0.63). 264/631 (41.8%) LR-4 observations in 447 patients had concurrent LR-5. The PPV for LR-4 observations with concurrent LR-5 was not significantly different from LR-4 observations without concurrent LR-5 (88.6% vs 69.5%, p = 0.08). A sensitivity analysis for low-risk of bias studies (n = 9) did not differ from the primary analysis.ConclusionThe presence of concurrent LR-5 was not significantly associated with differences in PPV for HCC in LR-3 or LR-4 observations, supporting the current LI-RADS paradigm, wherein the presence of synchronous LR-5 may not alter the categorization of LR-3 and LR-4 observations.

引用

页码：1533 / 1546

页数：14

共 55 条

[1] LI-RADS for CT diagnosis of hepatocellular carcinoma: performance of major and ancillary features [J].