Hepatocellular carcinoma (HCC) versus non-HCC: accuracy and reliability of Liver Imaging Reporting and Data System v2018

Daniel R. Ludwig*, Tyler J. Fraum, Roberto Cannella, David H. Ballard, Richard Tsai, Muhammad Naeem, Maverick LeBlanc, Amber Salter, Allan Tsung, Anup S. Shetty, Amir A. Borhani, Alessandro Furlan, Kathryn J. Fowler

*Corresponding author for this work

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Purpose: The Liver Imaging Reporting and Data System (LI-RADS) was created to standardize the diagnostic criteria for hepatocellular carcinoma (HCC) and has undergone multiple revisions including a recent update in 2018 (v2018). The primary aim of this study was to determine the diagnostic performance and interrater reliability (IRR) of LI-RADS v2018 for distinguishing HCC from non-HCC primary hepatic malignancy in patients ‘at-risk’ for HCC. A secondary aim was to assess the impact of changes introduced in the v2018 diagnostic algorithm. Methods: This retrospective study combined a 10-year experience of pathologically proven primary liver malignancies from two large liver transplant centers. Two blinded readers independently evaluated each lesion and assigned a LI-RADS diagnostic category, additionally scoring all relevant imaging features. Changes in category based on the reader-provided features and the new v2018 criteria were assessed by a study coordinator. Results: The final study cohort comprised 105 HCCs and 73 non-HCC primarily liver malignancies. LI-RADS had a high specificity for distinguishing HCC from non-HCC (89% and 90% for reader 1 and reader 2, respectively), and IRR was moderate to substantial for final LI-RADS category and most features. Revision of the LI-RADS v2018 diagnostic algorithm resulted in very few changes [5 (2.8%) and 3 (1.7%) for reader 1 and reader 2, respectively] in overall lesion classification. Conclusion: LI-RADS diagnostic categories and features had moderate to substantial IRR and high specificity for distinguishing HCC from non-HCC primary liver malignancy. Revision of LI-RADS v2018 diagnostic algorithm resulted in reclassification of very few lesions.

Original languageEnglish (US)
Pages (from-to)2116-2132
Number of pages17
JournalAbdominal Radiology
Volume44
Issue number6
DOIs
StatePublished - Jun 15 2019
Externally publishedYes

Keywords

  • Cirrhosis
  • Combined hepatocellular-cholangiocarcinoma (cHCC-CCA)
  • Interrater reliability
  • Intrahepatic cholangiocarcinoma (iCCA)
  • LI-RADS

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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    Ludwig, D. R., Fraum, T. J., Cannella, R., Ballard, D. H., Tsai, R., Naeem, M., LeBlanc, M., Salter, A., Tsung, A., Shetty, A. S., Borhani, A. A., Furlan, A., & Fowler, K. J. (2019). Hepatocellular carcinoma (HCC) versus non-HCC: accuracy and reliability of Liver Imaging Reporting and Data System v2018. Abdominal Radiology, 44(6), 2116-2132. https://doi.org/10.1007/s00261-019-01948-x