Hepatocellular Carcinoma Likelihood on MRI Exams: Evaluation of a Standardized Categorization System

被引:18
作者
Petruzzi, Nicholas [1 ]
Mitchell, Donald [1 ]
Guglielmo, Flavius [1 ]
O'Kane, Patrick [1 ]
Deshmukh, Sandeep [1 ]
Roth, Christopher [1 ]
Shortt, Conor [2 ]
Balfour, Stephen [1 ]
Parker, Laurence [1 ]
机构
[1] Thomas Jefferson Univ Hosp, Dept Radiol, Philadelphia, PA 19107 USA
[2] Mater Private Hosp, Dublin, Ireland
关键词
Hepatocellular carcinoma; standardized reporting; structured reporting; LIRADS; LI-RADS; HCC; liver MRI; LIVER-TRANSPLANTATION;
D O I
10.1016/j.acra.2013.01.016
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
Purpose: Evaluate the reliability and validity of a standardized reporting system designed to improve communication between the clinician and radiologist regarding likelihood of hepatocellular carcinoma (HCC). Materials and Methods: The system assigns liver lesions into 1 of 5 categories of estimated likelihood of HCC: 1, <5%; 2, 5%-20%; 3, 21%-70%; 4, 71%-95%; 5, >95%. Six American Board of Radiology-certified radiologists reviewed 100 abdominal MRI studies (performed between September 2009 and June 2010 for HCC surveillance) blinded to the official reports and clinical information. Each reader recorded the highest category (1-5) assigned to any lesion per study. Reliability between readers was calculated by the Shrout-Fliess random sets intraclass correlation (ICC). To examine validity, original pretransplant reports from January 2009 to December 2010 were compared to pathology reports on liver explants. Sensitivities, specificities, predictive values, and receiver operating characteristic (ROC) curves were then produced. Results: The ICC for retrospective readings was 0.80, indicating very good reliability. Of 45 pathologically proven cases, 16 category 1 or 2 cases were all free of HCC (negative predictive value 100%). Five of nine category 3 cases contained HCC. Six of eight category 4 cases contained HCC (PPV 75%). All 12 category 5 cases contained HCC (positive predictive value 100%). The area underneath the ROC curve was 0.949. If categories 1 and 2 are considered negative and categories 3-5 considered positive, this achieves 100% sensitivity with 73% specificity. Conclusion: This standardized system for reporting likelihood of HOC, which is a forerunner of the recently introduced Liver Imaging Reporting and Data System, produces strong reliability and validity, while aiming to improve the clarity of clinical magnetic resonance imaging reports.
引用
收藏
页码:694 / 698
页数:5
相关论文
共 23 条
[1]   Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005 [J].
Altekruse, Sean F. ;
McGlynn, Katherine A. ;
Reichman, Marsha E. .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (09) :1485-1491
[2]  
American College of Radiology, 2011, LI RADS LIV IM REP D
[3]  
[Anonymous], 2003, BREAST IM REP DAT SY
[4]   Detection of hepatocellular carcinoma: Combined T2-weighted and dynamic gadolinium-enhanced MRI versus combined CT during arterial portography and CT hepatic arteriography [J].
Choi, D ;
Kim, SH ;
Lim, JH ;
Cho, JM ;
Lee, WJ ;
Lee, SJ ;
Lim, HK .
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 2001, 25 (05) :777-785
[5]   Hepatocellular carcinoma in liver transplantation candidates: Detection with gadobenate dimeglumine-enhanced MRI [J].
Choi, Seung Hong ;
Lee, Jeong Min ;
Yu, Nam C. ;
Suh, Kyung-Suk ;
Jang, Ja-June ;
Kim, Se Hyung ;
Choi, Byung Ihn .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2008, 191 (02) :529-536
[6]  
DOrsi CJ, 1997, AM FAM PHYSICIAN, V55, P1548
[7]   Radiology Reporting and Communications: A Look Forward [J].
Flanders, Adam E. ;
Lakhani, Paras .
NEUROIMAGING CLINICS OF NORTH AMERICA, 2012, 22 (03) :477-+
[8]   EQUIVALENCE OF WEIGHTED KAPPA AND INTRACLASS CORRELATION COEFFICIENT AS MEASURES OF RELIABILITY [J].
FLEISS, JL ;
COHEN, J .
EDUCATIONAL AND PSYCHOLOGICAL MEASUREMENT, 1973, 33 (03) :613-619
[9]   Toward Best Practices in Radiology Reporting [J].
Kahn, Charles E., Jr. ;
Langlotz, Curtis P. ;
Burnside, Elizabeth S. ;
Carrino, John A. ;
Channin, David S. ;
Hovsepian, David M. ;
Rubin, Daniel L. .
RADIOLOGY, 2009, 252 (03) :852-856
[10]   Is terminology used effectively to convey diagnostic certainty in radiology reports? [J].
Khorasani, R ;
Bates, DW ;
Teeger, S ;
Rothschild, JM ;
Adams, DF ;
Seltzer, SE .
ACADEMIC RADIOLOGY, 2003, 10 (06) :685-688