Department of Radiology, Montefiore Medical Center, New York, NY.
Department of Radiology, Westchester Medical Center, Valhalla, NY.
Liver Transpl. 2019 Oct;25(10):1488-1502. doi: 10.1002/lt.25614. Epub 2019 Sep 9.
The purpose of this study was to assess the concordance in categorization and radiologic T staging using Liver Imaging Reporting and Data System (LI-RADS, LR) version 2017 (v2017), version 2018 (v2018), and the Organ Procurement and Transplantation Network (OPTN) criteria. All magnetic resonance imaging and computed tomography reports using a standardized LI-RADS macro between April 2015 and March 2018 were identified retrospectively. The major features (size, arterial phase hyperenhancement, washout, enhancing capsule, or threshold growth) were extracted from the report for each LR-3, LR-4, and LR-5 observation. Each observation was assigned a new category based on LI-RADS v2017, v2018, and OPTN criteria. Radiologic T stage was calculated based on the size and number of LR-5 or OPTN class 5 observations. Categories and T stages assigned by each system were compared descriptively. There were 398 patients (66.6% male; mean age, 63.4 years) with 641 observations (median size, 14 mm) who were included. A total of 73/182 (40.1%) observations categorized LR-4 by LI-RADS v2017 were up-categorized to LR-5 by LI-RADS v2018 due to changes in the LR-5 criteria, and 4/196 (2.0%) observations categorized as LR-5 by LI-RADS v2017 were down-categorized to LR-4 by LI-RADS v2018 due to changes in the threshold growth definition. The T stage was higher by LI-RADS v2018 than LI-RADS v2017 in 49/398 (12.3%) patients. Compared with the OPTN stage, 12/398 (3.0%) patients were upstaged by LI-RADS v2017 and 60/398 (15.1%) by LI-RADS v2018. Of 101 patients, 5 (5.0%) patients with T2 stage based on LI-RADS v2017 and 10/102 (9.8%) patients with T2 stage based on LI-RADS v2018 did not meet the T2 criteria based on the OPTN criteria. Of the 98 patients with a T2 stage based on OPTN criteria, 2 (2.0%) had a T stage ≥3 based on LI-RADS v2017 and 6 (6.1%) had a T stage ≥3 based on LI-RADS v2018.
本研究旨在评估使用肝脏成像报告和数据系统 (LI-RADS，LR) 2017 版 (v2017)、2018 版 (v2018) 和器官采购与移植网络 (OPTN) 标准进行分类和放射学 T 分期的一致性。回顾性分析了 2015 年 4 月至 2018 年 3 月期间使用标准化 LI-RADS 宏的所有磁共振成像和计算机断层扫描报告。从报告中提取每个 LR-3、LR-4 和 LR-5 观察的主要特征（大小、动脉期增强、洗脱、增强包膜或阈值生长）。根据 LI-RADS v2017、v2018 和 OPTN 标准为每个 LR-3、LR-4 和 LR-5 观察分配新类别。根据 LR-5 或 OPTN 类 5 观察的大小和数量计算放射学 T 分期。描述性比较每个系统分配的类别和 T 分期。共有 398 名患者（66.6%为男性；平均年龄 63.4 岁），641 个观察（中位数大小为 14mm）纳入研究。由于 LR-5 标准的变化，LI-RADS v2017 中分类为 LR-4 的 73/182（40.1%）观察被升级为 LR-5，由于阈值生长定义的变化，LI-RADS v2017 中分类为 LR-5 的 4/196（2.0%）观察被降级为 LR-4。在 49/398（12.3%）名患者中，LI-RADS v2018 的 T 分期高于 LI-RADS v2017。与 OPTN 分期相比，LI-RADS v2017 中有 12/398（3.0%）名患者分期上调，LI-RADS v2018 中有 60/398（15.1%）名患者分期上调。在 101 名患者中，5 名（5.0%）患者基于 LI-RADS v2017 的 T2 分期和 10 名（9.8%）患者基于 LI-RADS v2018 的 T2 分期不符合 OPTN 标准的 T2 标准。在基于 OPTN 标准的 98 名 T2 期患者中，LI-RADS v2017 中有 2 名（2.0%）患者的 T 分期≥3，LI-RADS v2018 中有 6 名（6.1%）患者的 T 分期≥3。
