评估在进行肝细胞癌监测的脆弱患者中，对美国 LI-RADS 随访建议的依从性。
Assessing Adherence to US LI-RADS Follow-up Recommendations in Vulnerable Patients Undergoing Hepatocellular Carcinoma Surveillance.
机构信息
From the Department of Radiology and Biomedical Imaging, University of California San Francisco, Zuckerberg San Francisco General Hospital, 505 Parnassus Ave, Box 0628, Room 255, San Francisco, CA 94143 (H.H.C., D.J.S.); and Department of Medicine, Division of General Internal Medicine (S.K., R.K.F.), Department of Epidemiology and Biostatistics (C.Y.H., A.S.), and Department of Medicine, Division of Gastroenterology and Hepatology (M.K.), University of California San Francisco, San Francisco, Calif.
出版信息
Radiol Imaging Cancer. 2024 Jan;6(1):e230118. doi: 10.1148/rycan.230118.
Purpose To assess adherence to the US Liver Imaging Reporting and Data System (LI-RADS) recommendations for hepatocellular carcinoma (HCC) surveillance and associated patient-level factors in a vulnerable, diverse patient sample. Materials and Methods The radiology report database was queried retrospectively for patients who underwent US LI-RADS-based surveillance examinations at a single institution between June 1, 2020, and February 28, 2021. Initial US and follow-up liver imaging were included. Sociodemographic and clinical data were captured from electronic medical records. Adherence to radiologist recommendation was defined as imaging (US, CT, or MRI) follow-up in 5-7 months for US-1, imaging follow-up in 3-6 months for US-2, and CT or MRI follow-up in 2 months for US-3. Descriptive analysis and multivariable modeling that adjusted for age, sex, race, and time since COVID-19 pandemic onset were performed. Results Among 936 patients, the mean age was 59.1 years; 531 patients (56.7%) were male and 544 (58.1%) were Asian or Pacific Islander, 91 (9.7%) were Black, 129 (13.8%) were Hispanic, 147 (15.7%) were White, and 25 (2.7%) self-reported as other race. The overall adherence rate was 38.8% (95% CI: 35.7, 41.9). The most common liver disease etiology was hepatitis B (60.6% [657 of 936 patients]); 19.7% of patients (183 of 936) had current or past substance use disorder, and 44.8% (416 of 936) smoked. At adjusted multivariable analysis, older age (odds ratio [OR], 1.20; = .02), male sex (OR, 1.62; = .003), hepatology clinic attendance (OR, 3.81; < .001), and recent prior US examination (OR, 2.44; < .001) were associated with full adherence, while current smoking (OR, 0.39; < .001) was negatively associated. Conclusion Adherence to HCC imaging surveillance was suboptimal, despite US LI-RADS implementation. Liver, Ultrasound, Screening, Abdomen/GI, Cirrhosis, Metabolic Disorders, Socioeconomic Issues . © RSNA, 2024.
目的 在美国肝成像报告和数据系统 (LI-RADS) 推荐的肝癌 (HCC) 监测中评估对建议的依从性，并在易受影响的多样化患者样本中评估与患者相关的因素。
材料与方法 对 2020 年 6 月 1 日至 2021 年 2 月 28 日期间在一家机构接受基于 US LI-RADS 的监测检查的患者的放射学报告数据库进行回顾性查询。纳入初始 US 和随访肝脏成像。从电子病历中获取社会人口统计学和临床数据。将放射科医生建议的依从性定义为：US-1 时在 5-7 个月进行影像学随访，US-2 时在 3-6 个月进行影像学随访，US-3 时在 2 个月进行 CT 或 MRI 随访。进行描述性分析和多变量建模，调整年龄、性别、种族和 COVID-19 大流行开始以来的时间。
结果 在 936 名患者中，平均年龄为 59.1 岁；531 名患者（56.7%）为男性，544 名（58.1%）为亚裔或太平洋岛民，91 名（9.7%）为黑人，129 名（13.8%）为西班牙裔，147 名（15.7%）为白人，25 名（2.7%）自报其他种族。总体依从率为 38.8%（95%CI：35.7，41.9）。最常见的肝病病因是乙型肝炎（60.6%[936 例患者中的 657 例]）；19.7%的患者（936 例中有 183 例）有当前或过去的药物使用障碍，44.8%（936 例中有 416 例）吸烟。在调整后的多变量分析中，年龄较大（比值比[OR]，1.20； =.02）、男性（OR，1.62； =.003）、肝科就诊（OR，3.81； <.001）和近期进行的 US 检查（OR，2.44； <.001）与完全依从相关，而当前吸烟（OR，0.39； <.001）与依从性呈负相关。
结论 尽管实施了 US LI-RADS，但 HCC 成像监测的依从性仍不理想。
肝脏，超声，筛查，腹部/胃肠道，肝硬化，代谢紊乱，社会经济问题。
© RSNA，2024。
Zotero 插件