Diagnostic Performance of 2018 KLCA-NCC Practice Guideline for Hepatocellular Carcinoma on Gadoxetic Acid-Enhanced MRI in Patients with Chronic Hepatitis B or Cirrhosis: Comparison with LI-RADS Version 2018
- Authors
- Lee Sang Min; Lee Jeong Min; Ahn Su Joa; Kang Hyo-Jin; Yang Hyun Kyung; Yoon Jeong Hee
- Issue Date
- Jul-2021
- Publisher
- 대한영상의학회
- Keywords
- Diagnosis; Liver neoplasm; Hepatocellular carcinoma; Magnetic resonance imaging; Gadoxetic acid
- Citation
- Korean Journal of Radiology, v.22, no.7, pp.1066 - 1076
- Journal Title
- Korean Journal of Radiology
- Volume
- 22
- Number
- 7
- Start Page
- 1066
- End Page
- 1076
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/81833
- DOI
- 10.3348/kjr.2020.0846
- ISSN
- 1229-6929
- Abstract
- Objective: To evaluate the performance of the 2018 Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) Practice Guidelines (hereafter, PG) for the diagnosis of hepatocellular carcinoma (HCC) using gadoxetic acid-enhanced MRI, compared to the Liver Imaging-Reporting and Data System (LI-RADS) version 2018 (hereafter, v2018).
Materials and Methods: From January 2013 to October 2015, treatment-naïve hepatic lesions (≥ 1 cm) on gadoxetic acidenhanced MRI in consecutive patients with chronic hepatitis B or cirrhosis were retrospectively evaluated. For each lesion, three radiologists independently analyzed the imaging features and classified the lesions into categories according to the 2018 KLCA-NCC PG and LI-RADS v2018. The imaging features and categories were determined by consensus. Generalized estimating equation (GEE) models were used to compare the per-lesion diagnostic performance of the 2018 KLCA-NCC PG and LI-RADS v2018 using the consensus data.
Results: In total, 422 lesions (234 HCCs, 45 non-HCC malignancies, and 143 benign lesions) from 387 patients (79% male; mean age, 59 years) were included. In all lesions, the definite HCC (2018 KLCA-NCC PG) had a higher sensitivity and lower specificity than LR-5 (LI-RADS v2018) (87.2% [204/234] vs. 80.8% [189/234], p < 0.001; 86.2% [162/188] vs. 91.0% [171/188], p = 0.002). However, in lesions of size ≥ 2 cm, the definite HCC had a higher sensitivity than the LR-5 (86.8% [164/189] vs. 82.0 (155/189), p = 0.002) without a reduction in the specificity (80.0% [48/60] vs. 83.3% [50/60], p = 0.15). In all lesions, the sensitivity and specificity of the definite/probable HCC (2018 KLCA-NCC PG) and LR-5/4 did not differ significantly (89.7% [210/234] vs. 91.5% [214/234], p = 0.204; 83.5% [157/188] vs. 79.3% [149/188], p = 0.071).
Conclusion: For the diagnosis of HCC of size ≥ 2 cm, the definite HCC (2018 KLCA-NCC PG) had a higher sensitivity than LR-5, without a reduction in specificity. The definite/probable HCC (2018 KLCA-NCC PG) had a similar sensitivity and specificity to that those of the LR-5/4.
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