ACR Ultrasound Liver Reporting and Data System: Multicenter Assessment of Clinical Performance at One Year

被引:25
作者
Millet, John D. [1 ]
Kamaya, Aya [2 ]
Choi, Hailey H. [3 ]
Dahiya, Nirvikar [4 ]
Murphy, Paul M. [5 ]
Naveed, Mujtaba Z. [6 ]
O'Boyle, Mary [5 ]
Parra, Laura A. [4 ]
Perez, Marcelina G. [2 ]
Pirmoazen, Amir M. [2 ]
Rodgers, Shuchi K. [6 ]
Wasnik, Ashish P. [1 ]
Maturen, Katherine E. [1 ]
机构
[1] Univ Michigan, Dept Radiol, Michigan Med, UH B1-D502,1500 East Med Ctr Dr, Ann Arbor, MI 48109 USA
[2] Stanford Univ, Dept Radiol, Stanford, CA USA
[3] Univ Calif San Francisco, Dept Radiol & Biomed Imaging, San Francisco, CA 94143 USA
[4] Mayo Clin, Dept Radiol, Phoenix, AZ USA
[5] Univ Calif San Diego, Dept Radiol, San Diego, CA 92103 USA
[6] Einstein Med Ctr, Dept Radiol, Philadelphia, PA USA
基金
美国国家卫生研究院;
关键词
Ultrasound; LI-RADS; hepatocellular carcinoma; screening; surveillance; HEPATOCELLULAR-CARCINOMA; SURVEILLANCE; CT; DIAGNOSIS;
D O I
10.1016/j.jacr.2019.05.020
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: The aim of this study was to evaluate the clinical performance of the ACR's Ultrasound Liver Reporting and Data System (US LI-RADS (TM)) for detecting hepatocellular carcinoma (HCC) in patients at high risk for HCC. Methods: In this retrospective, multicenter study, 2,050 patients at high risk for HCC (1,078 men and 972 women; mean age, 57.7 years) at five sites in the United States had undergone screening liver ultrasound from January 2017 to February 2018, and US LI-RADS observation categories and visualization scores were assigned on a clinical basis. Ultrasound reports and patient records were retrospectively reviewed and follow-up imaging studies and/or pathologic reports recorded. Descriptive statistics were generated, and multivariate logistic regression analysis was used to analyze the relationship of clinical and reader-based predictors of limited visualization. Diagnostic performance data were calculated in the subset of patients with confirmatory testing. Results: The most common indications for HCC screening were cirrhosis (n = 1,054 [51.4%]), noncirrhotic hepatitis B virus infection (n = 555 [27.1%}), and noncirrhotic hepatitis C virus infection (n = 234 [11.4%]). US LI-RADS observation categories assigned were US-1 (negative) in 90.4% (n = 1,854), US-2 (subthreshold) in 4.6% (n = 95), and US-3 (positive) in 4.9% (n = 101). Visualization scores were A (no or minimal limitations) in 76.8% (n = 1,575), B (moderate limitations) in 18.9% (n = 388), and C (severe limitations) in 4.2% (n = 87). Confirmatory tests, including multiphase contrast-enhanced CT or MRI (n = 331) or histopathology (n = 18), were available for 349 patients (17.0%). The sensitivity of US LI-RADS in this subset of patients was 82.4%, specificity was 74.2%, positive predictive value was 35.3%, and negative predictive value was 96.1%. Conclusions: Approximately 90% of US LI-RADS screening examinations were negative, 5% subthreshold, and 5% positive. Visualization scores were diagnostically acceptable in the vast majority (>95%) of examinations. US LI-RADS emphasized sensitivity and negative predictive value, which are key characteristics of a screening test.
引用
收藏
页码:1656 / 1662
页数:7
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