A retrospective single-centre analysis of the oncological impact of LI-RADS classification applied to Metroticket 2.0 calculator in liver transplantation: every nodule matters
| Autor: | Cristina Ciulli, Leonardo Centonze, Ivan Vella, Stefano Di Sandro, Ilaria Vicentin, Andrea Lauterio, Cristiano Sgrazzutti, Niccolò Incarbone, Luciano De Carlis, Riccardo De Carlis, Angelo Vanzulli, Vincenzo Bagnardi |
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| Přispěvatelé: | Centonze, L, Di Sandro, S, Lauterio, A, De Carlis, R, Sgrazzutti, C, Ciulli, C, Vella, I, Vicentin, I, Incarbone, N, Bagnardi, V, Vanzulli, A, De Carlis, L |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Carcinoma Hepatocellular medicine.medical_treatment Contrast Media Liver transplantation Sensitivity and Specificity liver imaging law.invention law medicine hepatocellular carcinoma LI-RADS liver transplantation Metroticket 2.0 tumour staging Humans Liver imaging Retrospective Studies Transplantation business.industry Liver Neoplasms Nodule (medicine) Retrospective cohort study medicine.disease Magnetic Resonance Imaging Confidence interval Liver Transplantation Single centre Calculator Hepatocellular carcinoma Radiology medicine.symptom business Tomography X-Ray Computed |
| Zdroj: | Transplant international : official journal of the European Society for Organ TransplantationReferences. 34(9) |
| ISSN: | 1432-2277 |
| Popis: | Although the diagnostic value of Liver Imaging Reporting and Data System (LI-RADS) protocol is well recognized in clinical practice, its role in liver transplant (LT) setting is under-explored. We sought to evaluate the oncological impact of LI-RADS classification applied to Metroticket 2.0 calculator in a single-centre retrospective cohort of transplanted hepatocellular carcinoma (HCC) patients, exploring which LI-RADS subclasses need to be considered in order to grant the best Metroticket 2.0 performance. The most recent pre-LT imaging of 245 patients undergoing LT for HCC between 2005 and 2015 was retrospectively and blindly reviewed, classifying all nodules according to LI-RADS protocol. Metroticket 2.0 accuracy was subsequently tested incorporating all vital nodules identified during multi-disciplinary team (MDT) meetings attended before LI-RADS reclassification of the latest pre-LT imaging, LR-5 and LR-treatment-viable (LR-TR-V), LR-4/5 and LR-TR-V, and LR-3/4/5 and LR-TR-V nodules respectively. Considering their extremely low probability for harbouring HCC, LR-1 and LR-2 nodules were not considered in this analysis. Incorporation of all HCCs identified during MDT meetings attended before LI-RADS reclassification of the latest pre-LT imaging resulted in a Metroticket 2.0 c-index of 0.72, [95% confidence interval (CI) 0.64–0.80]. Metroticket 2.0 c-index dropped to 0.60 [95% CI: 0.48–0.72] when LI-RADS-5 and LI-RADS-TR-V (P=0.0089) or LI-RADS-5, LI-RADS-4 and LI-RADS-TR-V (P=0.0068) nodules were entered in the calculator. Conversely, addition of LI-RADS-3 HCCs raised the Metroticket 2.0 c-index to 0.65 [95% CI: 0.54–0.86], resulting in a not statistically significant diversion from the original performance (0.72 vs. 0.65; P=0.08). Exclusion of LR-3 and LR-4 nodules from Metroticket 2.0 calculator resulted in a significant drop in its accuracy. Every nodule with an intermediate-to-high probability of harbouring HCC according to LI-RADS protocol seems to contribute to tumour burden and should be entered in the Metroticket 2.0 calculator in order to grant appropriate performance. |
| Databáze: | OpenAIRE |
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