Does a combined CT and MRI protocol enhance the diagnostic efficacy of LI-RADS in the categorization of hepatic observations? A prospective comparative study.

Autor: Basha MAA; Department of Diagnostic Radiology, Zagazig University, Zagazig, Egypt. drmohammad_basha@yahoo.com., AlAzzazy MZ; Department of Diagnostic Radiology, Zagazig University, Zagazig, Egypt., Ahmed AF; Department of Diagnostic Radiology, Zagazig University, Zagazig, Egypt., Yousef HY; Department of Diagnostic Radiology, Zagazig University, Zagazig, Egypt., Shehata SM; Department of Diagnostic Radiology, Zagazig University, Zagazig, Egypt., El Sammak DAEA; Department of Diagnostic Radiology, Zagazig University, Zagazig, Egypt., Fathy T; Department of Tropical Medicine, Zagazig University, Zagazig, Egypt., Obaya AA; Department of Clinical Oncology, Zagazig University, Zagazig, Egypt., Abdelbary EH; Department of Pathology, Zagazig University, Zagazig, Egypt.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2018 Jun; Vol. 28 (6), pp. 2592-2603. Date of Electronic Publication: 2018 Jan 24.
DOI: 10.1007/s00330-017-5232-y
Abstrakt: Objective: To compare diagnostic performance and agreement between CT, MRI and combined CT/MRI in reference to LI-RADS classification system to categorize hepatic observations detected in hepatic patients during screening ultrasound.
Methods: 240 patients with 296 liver observations detected during ultrasound surveillance underwent hepatic CT and MRI examinations, histopathology, and clinical and radiological follow-up. Using LI-RADS v2014, six radiologists evaluated the observations independently and assigned a LI-RADS category to each observation using CT, MRI and combined CT/MRI.
Results: Combined CT and MRI in LI-RADS yielded better accuracy (91.29 %), sensitivity (90.71 %) and specificity (92.31 %) for hepatocellular carcinoma (HCC) diagnosis than using MRI or CT alone; accuracy, sensitivity and specificity decreased to 85.37 %, 86.34 %, and 83.65 %, respectively, for MRI and 67.6 %, 54.10 % and 91.35 %, respectively, for CT. The intraclass agreement of the LI-RADS scores between CT, MRI and combined CT/MRI was excellent (κ=0.9624 (95 % CI: 0.9318-0.9806)).
Conclusion: CT and MRI are complementary to each other. Combined CT/MRI enabled a more precise determination of LI-RADS category of hepatic observations; however, due to the expense and minor increase in accuracy, the combined methodology should only be utilized in cases of suspected HCC.
Key Points: • Hepatic observation may be categorized differently depending on the imaging modality used. • We compared LI-RADS categorization between CT, MRI and combined CT/MRI. • MRI produces higher accuracy and sensitivity, while CT produces higher specificity. • Combining CT and MRI improves LIRADS categorization reports. • Considering additional cost, combined methodology could be restricted to challenging cases.
Databáze: MEDLINE
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