Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Postal address 430030, Qiaokou District, Wuhan, Hubei Province, China.
Cancer Imaging. 2023 Mar 6;23(1):24. doi: 10.1186/s40644-023-00541-2.
This study evaluated the performance of the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) in patients without LI-RADS-defined hepatocellular carcinoma (HCC) risk factors (RF-).
Patients with LI-RADS-defined HCC risk factors (RF+) and RF- were enrolled in a retrospective study. Additionally, a prospective evaluation in the same centre was performed as a validation set. The diagnostic performances of the CEUS LI-RADS criteria in RF+ and RF- patients were compared.
Overall, we included 873 patients in the analyses. In the retrospective study, the LI-RADS category (LR)-5 specificities for diagnosing HCC did not differ between the RF+ and RF- groups (77.5% [158/204] vs 91.6% [196/214], P = 0.369, respectively). However, the positive predictive value (PPV) of CEUS LR-5 was 95.9% (162/169) and 89.8% (158/176) in the RF+ and RF- groups, respectively (P = 0.029). In the prospective study, the PPV of LR-5 for HCC lesions was significantly higher in the RF+ group than in the RF- group (P = 0.030). The sensitivity and specificity did not differ between the RF+ and RF- groups (P = 0.845 and P = 0.577, respectively).
The CEUS LR-5 criteria shows clinical value for diagnosis of HCC in patients with and without risks.
本研究评估了增强超声（CEUS）肝脏成像报告和数据系统（LI-RADS）在无 LI-RADS 定义的肝细胞癌（HCC）风险因素（RF-）患者中的性能。
LI-RADS 定义的 HCC 风险因素（RF+）和 RF-患者纳入回顾性研究。此外，在同一中心进行了前瞻性评估作为验证集。比较了 RF+和 RF-患者中 CEUS LI-RADS 标准的诊断性能。
总体而言，我们对 873 名患者进行了分析。在回顾性研究中，RF+和 RF-组中诊断 HCC 的 CEUS LI-RADS 类别（LR）5 的特异性无差异（77.5%[158/204]与 91.6%[196/214]，P=0.369）。然而，CEUS LR-5 的阳性预测值（PPV）在 RF+和 RF-组中分别为 95.9%（162/169）和 89.8%（158/176）（P=0.029）。在前瞻性研究中，LR-5 对 HCC 病变的 PPV 在 RF+组中显著高于 RF-组（P=0.030）。RF+和 RF-组之间的敏感性和特异性没有差异（P=0.845 和 P=0.577）。
CEUS LR-5 标准对有和无风险的患者 HCC 的诊断具有临床价值。
