Sevim Sezgin, Dicle Oğuz, Gezer Naciye S, Barış Mustafa M, Altay Canan, Akın Işıl Başara
Department of Radiology, School of Medicine, Dokuz Eylül University, İnciraltı, İzmir, Turkey.
Pol J Radiol. 2019 Nov 18;84:e464-e469. doi: 10.5114/pjr.2019.90090. eCollection 2019.
To investigate the reproducibility of LIRADS v2014 and contribute to its widespread use in clinical practice.
This retrospective, single-centre study was conducted between January 2010 and October 2015. A total of 132 patients who had dynamic magnetic resonance imaging (MRI)/computed tomography (CT) images in the Picture Archiving and Communication Systems (PACS) with liver nodule were included in the study, 37 of whom had histopathology results. Five radiologists who participated in the study, interpreted liver nodules independently on different PACS stations according to the LIRADS reporting system and its main parameters.
We determined that level of inter-observer agreement in the LR-1, LR-5, and LR-5V categories was higher than in the LR-2, LR-3, and LR-4 categories (κ = 0.522, 0.442, and 0.600 in the LR-1, LR-5, and LR-5V categories, respectively; κ = 0.082, 0.298, and 0.143 in the LR-2, LR-3, and LR-4 categories, respectively). The parameter that we observed to have the highest level of inter-observer agreement was venous thrombus (κ = 0.600).
Our study showed that LIRADS achieves an acceptable inter-observer reproducibility in terms of clinical practice although it is insufficient at intermediate risk levels. We think that the prevalence of its use will be further increased with training related to the subject and the assignment of numerical values that express the probability of malignancy for each category and including the ancillary features in the algorithm according to clearer
研究LIRADS v2014的可重复性，并促进其在临床实践中的广泛应用。
本回顾性单中心研究于2010年1月至2015年10月进行。共有132例在图像存档与通信系统（PACS）中有肝脏结节动态磁共振成像（MRI）/计算机断层扫描（CT）图像的患者纳入研究，其中37例有组织病理学结果。参与研究的5名放射科医生根据LIRADS报告系统及其主要参数在不同的PACS工作站上独立解读肝脏结节。
我们确定，LR-1、LR-5和LR-5V类别的观察者间一致性水平高于LR-2、LR-3和LR-4类别（LR-1、LR-5和LR-5V类别的κ分别为0.522、0.442和0.600；LR-2、LR-3和LR-4类别的κ分别为0.082、0.298和0.143）。我们观察到观察者间一致性水平最高的参数是静脉血栓（κ = 0.600）。
我们的研究表明，尽管LIRADS在中等风险水平上不够充分，但在临床实践中观察者间可重复性达到了可接受的水平。我们认为，通过与该主题相关的培训以及为每个类别赋予表示恶性概率的数值，并根据更清晰的算法纳入辅助特征，其使用普及率将进一步提高。
