Diagnostic performance of ultrasonography-guided core-needle biopsy according to MRI LI-RADS diagnostic categories
- Authors
- Kim, Dong Wook; Kim, So Yeon; Kang, Hyo Jeong; Kang, Ji Hun; Lee, Seung Soo; Shim, Ju Hyun; Choi, Sang Hyun; Shin, Yong Moon; Byun, Jae Ho
- Issue Date
- Jul-2021
- Publisher
- Korean Society of Ultrasound in Medicine
- Keywords
- Carcinoma, hepatocellular; Image-guided biopsy; Liver; Magnetic resonance imaging
- Citation
- Ultrasonography, v.40, no.3, pp.387 - 397
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Ultrasonography
- Volume
- 40
- Number
- 3
- Start Page
- 387
- End Page
- 397
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/189645
- DOI
- 10.14366/usg.20110
- ISSN
- 2288-5919
- Abstract
- Purpose: According to the American Association for the Study of Liver Diseases (AASLD) guidelines, biopsy is a diagnostic option for focal hepatic lesions depending on the Liver Imaging Reporting and Data System (LI-RADS) category. We evaluated the diagnostic performance of ultrasonography-guided core-needle biopsy (CNB) according to LI-RADS categories.
Methods: A total of 145 high-risk patients for hepatocellular carcinoma (HCC) who underwent magnetic resonance imaging (MRI) followed by CNB for a focal hepatic lesion preoperatively were retrospectively enrolled. Focal hepatic lesions on MRI were evaluated according to LI-RADS version 2018. Pathologic results were categorized into HCC, non-HCC malignancies, and benignity. The categorization was defined as correct when the CNB pathology and surgical pathology reports were identical. Nondiagnostic results were defined as inadequate CNB pathology findings for a specific diagnosis. The proportion of correct categorizations was calculated for each LI-RADS category, excluding nondiagnostic results.
Results: After excluding 16 nondiagnostic results, 131 lesions were analyzed (45 LR-5, 24 LR-4, 4 LR-3, and 58 LR-M). All LR-5 lesions were HCC, and CNB correctly categorized 97.8% (44/45) of LR-5 lesions. CNB correctly categorized all 24 LR-4 lesions, 16.7% (4/24) of which were non-HCC malignancies. All LR-M lesions were malignant, and 62.1% (36/58) were non-HCC malignancies. CNB correctly categorized 93.1% (54/58) of LR-M lesions, and 12.5% (3/24) of lesions with CNB results of HCC were confirmed as non-HCC malignancies.
Conclusion: In agreement with AASLD guidelines, CNB could be helpful for LR-4 lesions, but is unnecessary for LR-5 lesions. In LR-M lesions, CNB results of HCC did not exclude non-HCC malignancy.
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