EASL versus LI-RADS: Intra-individual comparison of MRI with extracellular contrast and gadoxetic acid for diagnosis of small HCC
- Authors
- Min, Ji Hye; Kim, Jong Man; Kim, Young Kon; Kim, Honsoul; Cha, Dong Ik; Kang, Tae Wook; Choi, Gyu Seong; Choi, Seo-Youn; Ahn, Soohyun
- Issue Date
- Dec-2021
- Publisher
- Blackwell Publishing Inc.
- Keywords
- contrast agent; EASL; hepatocellular carcinoma; LI-RADS; magnetic resonance imaging
- Citation
- Liver International, v.41, no.12, pp 2986 - 2996
- Pages
- 11
- Journal Title
- Liver International
- Volume
- 41
- Number
- 12
- Start Page
- 2986
- End Page
- 2996
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/20268
- DOI
- 10.1111/liv.15012
- ISSN
- 1478-3223
1478-3231
- Abstract
- Background & Aims Liver Imaging Reporting and Data System (LI-RADS) and European Association for the Study (EASL) criteria for hepatocellular carcinoma (HCC) diagnosis have been updated in 2018. We aimed to compare the HCC diagnostic performance of LI-RADS and EASL criteria with extracellular contrast agents-MRI (ECA-MRI) and hepatobiliary agents-MRI (HBA-MRI). Methods We prospectively evaluated 179 participants with cirrhosis (n = 105) or non-cirrhotic chronic hepatitis B (CHB) (n = 74) who underwent both ECA-MRI and HBA-MRI before surgery for de novo nodule(s) measuring 10-30 mm. We compared the HCC diagnostic performance of EASL and LR-5 in both MRIs. Results In an analysis of 215 observations (175 HCCs, 17 non-HCC malignancies and 23 benign lesions) identified from cirrhotic or non-cirrhotic CHB participants, LR-5 with ECA-MRI provided the highest sensitivity (80.7%), followed by EASL with ECA-MRI (76.2%), LR-5 with HBA-MRI (67.3%) and EASL with HBA-MRI (63.0%, all P < .05). The specificities were comparable (89.4%-91.5%). When the analysis is limited to participants with pathological cirrhosis (123 observations), the sensitivity of LR-5 with ECA-MRI was similar to that of EASL with ECA-MRI (82.7% vs 80.2%, P = .156), but higher than LR-5 with HBA-MRI (65.1%) or EASL with HBA-MRI (62.8%, both P < .001), with comparable specificities (87.5%-91.7%). Conclusions The LR-5 with ECA-MRI yielded the highest sensitivity with a similar specificity for HCC diagnosis in cirrhosis and non-cirrhotic CHB participants, while the sensitivities of LR-5 and EASL with ECA-MRI are similar for cirrhosis participants. This indicates non-invasive diagnosis criteria can differ by contrast agents and presence of cirrhosis.
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