Lee Sunyoung, Kim Seung-Seob, Roh Yun Ho, Choi Jin-Young, Park Mi-Suk, Kim Myeong-Jin
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.
Liver Int. 2020 Jun;40(6):1488-1497. doi: 10.1111/liv.14424. Epub 2020 Mar 19.
BACKGROUND & AIMS: The liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system for standardizing liver imaging in patients at high risk for hepatocellular carcinoma (HCC). We performed a meta-analysis to determine the diagnostic performance of the LR-5 category for HCC and the pooled proportions of HCCs in each LI-RADS category using CT/MRI LI-RADS v2017.
We searched multiple databases for original studies reporting on the diagnostic accuracy of CT/MRI LI-RADS v2017. Random-effects models were used to determine the summary estimates of the diagnostic performance of the LR-5 category and the pooled proportions of HCCs for each LI-RADS category. Risk of bias and concerns regarding applicability were evaluated with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
Fourteen studies (3 prospective studies and 11 retrospective studies) were included in the final analysis, consisting of 2056 patients, 2589 observations, and 1693 HCCs. The pooled per-observation sensitivity was 67% (95% confidence interval [CI], 62%-72%) with specificity of 92% (95% CI, 88%-95%) in the LR-5 category of CT/MRI LI-RADS v2017 for diagnosing HCC. The pooled proportions of HCCs were 0% (95% CI, 0%-0%) for LR-1, 4% (95% CI, 0%-8%) for LR-2, 34% (95% CI, 23%-44%) for LR-3, 67% (95% CI, 53%-81%) for LR-4, and 92% (95% CI, 87%-96%) for LR-5. The proportions of HCCs were significantly different among LI-RADS categories 1-5 (P = .034).
The LR-5 category of CT/MRI LI-RADS v2017 shows moderate sensitivity and high specificity for diagnosing HCC. Higher LI-RADS categories contained higher proportions of HCCs.
肝脏影像报告和数据系统（LI-RADS）是一个用于规范肝细胞癌（HCC）高危患者肝脏成像的综合系统。我们进行了一项荟萃分析，以确定使用CT/MRI LI-RADS v2017时，LR-5类别对HCC的诊断性能以及每个LI-RADS类别中HCC的合并比例。
我们在多个数据库中搜索报告CT/MRI LI-RADS v2017诊断准确性的原始研究。采用随机效应模型来确定LR-5类别的诊断性能汇总估计值以及每个LI-RADS类别的HCC合并比例。使用诊断准确性研究质量评估-2工具评估偏倚风险和适用性问题。
最终分析纳入了14项研究（3项前瞻性研究和11项回顾性研究），包括2056例患者、2589次观察和1693例HCC。在CT/MRI LI-RADS v2017的LR-5类别中，用于诊断HCC的每观察合并敏感性为67%（95%置信区间[CI]，62%-72%），特异性为92%（95%CI，88%-95%）。LR-1中HCC的合并比例为0%（95%CI，0%-0%），LR-2为4%（95%CI，0%-8%），LR-3为34%（95%CI，23%-44%），LR-4为67%（95%CI，53%-81%），LR-5为92%（95%CI，87%-96%）。LI-RADS类别1至5之间的HCC比例有显著差异（P = 0.034）。
CT/MRI LI-RADS v2017的LR-5类别对HCC诊断显示出中等敏感性和高特异性。LI-RADS类别越高，HCC比例越高。
