Shin Jaeseung, Lee Sunyoung, Bae Heejin, Chung Yong Eun, Choi Jin-Young, Huh Yong-Min, Park Mi-Suk
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Yonsei Biomedical Research Institute, Yonsei University Health System, Seoul, Korea.
Liver Int. 2020 Oct;40(10):2345-2352. doi: 10.1111/liv.14617. Epub 2020 Aug 8.
BACKGROUND & AIMS: Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system for standardizing CEUS at high risk for hepatocellular carcinoma (HCC). We performed a meta-analysis to determine the diagnostic performance of the CEUS LR-5 for HCC and the pooled proportions of HCCs in each CEUS LI-RADS category.
We searched multiple databases for studies reporting the diagnostic accuracy of the CEUS LI-RADS. Random-effects model was used to determine summary estimates of the diagnostic performance of CEUS LR-5 and the pooled proportions of HCCs in each CEUS LI-RADS category. Risk of bias and concerns regarding applicability were evaluated with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.
Eleven studies were included in the final analysis, which consisted of 5535 observations with 3983 HCCs. The pooled per-observation sensitivity and specificity of the CEUS LR-5 for diagnosing HCC were 69% (95% confidence interval [CI], 64%-73%) and 92% (95% CI, 83%-96%) respectively. The pooled proportions of HCCs were 0% (95% CI, 0-0%) for LR-1, 1% (95% CI, 0%-4%) for CEUS LR-2, 26% (95% CI, 14%-39%) for CEUS LR-3, 77% (95% CI, 68%-86%) for CEUS LR-4, 97% (95% CI, 95%-98%) for CEUS LR-5, 57% (95% CI, 44%-69%) for CEUS LR-M and 100% (95% CI, 93%-100%) for CEUS LR-5V or TIV.
The CEUS LR-5 category showed moderate sensitivity and high specificity for diagnosing HCC. The proportion of HCCs was higher in the higher CEUS LI-RADS categories.
对比增强超声（CEUS）肝脏影像报告和数据系统（LI-RADS）是一种用于规范肝细胞癌（HCC）高风险患者CEUS检查的综合系统。我们进行了一项荟萃分析，以确定CEUS LR-5对HCC的诊断性能以及每个CEUS LI-RADS类别中HCC的汇总比例。
我们在多个数据库中检索报告CEUS LI-RADS诊断准确性的研究。采用随机效应模型确定CEUS LR-5诊断性能的汇总估计值以及每个CEUS LI-RADS类别中HCC的汇总比例。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11项研究，共5535例观察对象，其中3983例为HCC。CEUS LR-5诊断HCC的观察对象汇总敏感性和特异性分别为69%（95%置信区间[CI]，64%-73%）和92%（95%CI，83%-96%）。LR-1类别中HCC的汇总比例为0%（95%CI，0-0%），CEUS LR-2为1%（95%CI，0%-4%），CEUS LR-3为26%（95%CI，14%-39%），CEUS LR-4为77%（95%CI，68%-86%），CEUS LR-5为97%（95%CI，95%-98%），CEUS LR-M为57%（95%CI，44%-69%），CEUS LR-5V或TIV为100%（95%CI，93%-100%）。
CEUS LR-5类别对HCC诊断具有中等敏感性和高特异性。在CEUS LI-RADS较高类别中HCC的比例更高。
