Department of Diagnostic Radiology, Mansoura Faculty of Medicine, 13551 Mansoura, Egypt.
Department of Diagnostic Radiology, Mansoura Faculty of Medicine, 13551 Mansoura, Egypt.
Diagn Interv Imaging. 2020 Sep;101(9):547-553. doi: 10.1016/j.diii.2020.03.008. Epub 2020 Apr 3.
To determine inter-reader agreement in categorizing hepatocellular carcinoma (HCC) treated with locoregional therapy using the Liver Imaging Reporting and Data System (LI-RADS) treatment response (LR-TR) algorithm.
A total of 93 patients with a total of 112 HCC nodules that were treated using thermal ablation or transarterial chemoembolization were prospectively included. There were 79 men and 14 women with a mean age of 55±2.6 (SD)years (range: 48-63years). All patients underwent magnetic resonance imaging (MRI) examination of the liver and MR images were analyzed by two independent observers. Treated HCC nodules were categorized into four groups according to LR-TR scoring system including: (i) LR-TR non-evaluable (treated, response not evaluable); (ii) LR-TR nonviable (treated, probably or definitively not viable); (iii) LR-TR equivocal (treated, equivocally viable) and (iv) LR-TR viable (treated, probably or definitively viable). The inter-observer agreement in LR-TR categorization was assessed using the kappa statistics.
There was excellent inter-observer agreement between the two reviewers for overall treated HCC according to LR-TR algorithm (kappa=0.938; 95% CI: 0.89-1.00; P=0.001) with 97.31% agreement. The LR-TR categories by both reviewers were non-viable (77/112; 69.6% and 76/112; 67.9%), viable (30/112; 26.8% and 32/112; 27.7%) and equivocal (5/112; 4.4% and 4/112; 3.6%). There was excellent inter-observer agreement for LR-TR nonviable (kappa=0.938; 95% CI: 0.87-1.0; P=0.001) with 97.3% agreement, LR-TR viable (kappa=0.955; 95% CI: 0.89-1.00; P=0.001) with 98.2% agreement and good inter-observer agreement for LR-TR equivocal (kappa=0.700; 95% CI: 0.28-1.0; P=0.001) with 97.3% agreement.
LR-TR algorithm conveys high degrees of inter-observer agreement for the evaluation of treatment response of HCC after thermal ablation and transarterial chemoembolization.
使用肝脏成像报告和数据系统 (LI-RADS) 治疗反应 (LR-TR) 算法确定对局部区域治疗的肝细胞癌 (HCC) 进行分类的读者间一致性。
前瞻性纳入 93 例共 112 个 HCC 结节接受热消融或经动脉化疗栓塞治疗的患者。79 名男性和 14 名女性，平均年龄 55±2.6(SD)岁(范围：48-63 岁)。所有患者均行肝脏磁共振成像(MRI)检查，由两位独立观察者进行 MR 图像分析。根据 LR-TR 评分系统，将治疗后的 HCC 结节分为以下四组：(i)LR-TR 不可评估(治疗，反应不可评估)；(ii)LR-TR 无活性(治疗，可能或明确无活性)；(iii)LR-TR 不确定(治疗，不确定有活性)和(iv)LR-TR 有活性(治疗，可能或明确有活性)。使用kappa 统计评估观察者间在 LR-TR 分类方面的一致性。
根据 LR-TR 算法，两位观察者对总体治疗后 HCC 的判断具有极好的观察者间一致性(kappa=0.938；95%CI：0.89-1.00；P=0.001)，一致性为 97.31%。两位观察者的 LR-TR 分类均为无活性(77/112；69.6%和 76/112；67.9%)、有活性(30/112；26.8%和 32/112；27.7%)和不确定(5/112；4.4%和 4/112；3.6%)。LR-TR 无活性(kappa=0.938；95%CI：0.87-1.0；P=0.001)的观察者间一致性极好，一致性为 97.3%，LR-TR 有活性(kappa=0.955；95%CI：0.89-1.00；P=0.001)的观察者间一致性极好，一致性为 98.2%，LR-TR 不确定(kappa=0.700；95%CI：0.28-1.0；P=0.001)的观察者间一致性为良好，一致性为 97.3%。
LR-TR 算法在评估 HCC 热消融和经动脉化疗栓塞治疗后的治疗反应方面具有高度的观察者间一致性。
