Diagnostic Accuracy of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) for Differentiating Between Hepatocellular Carcinoma and Other Hepatic Malignancies in High-Risk Patients: A Meta-Analysis

Abstract

Objectives The American College of Radiology (ACR) contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS), which includes diagnostic criteria for hepatocellular carcinoma (HCC) and other hepatic malignancies (OM), is increasingly used in clinical practice. This study performed a meta-analysis to assess the diagnostic accuracy of CEUS LI-RADS for differentiating between HCC and OM in high-risk patients.

Methods PubMed, Embase (Ovid), and Cochrane (CENTRAL) were searched for relevant studies. All studies that reported the percentage of HCC and OM in the LI-RADS categories were included. Random-effects models were used to calculate the pooled sensitivity and specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curve.

Results Eight studies involving 4215 focal liver lesions were included in the final analysis. The pooled sensitivity and specificity of the LR-5 criteria for HCC were 0.71 (95 % CI, 0.69–0.72) and 0.88 (0.85–0.91), respectively, the DOR was 18.36 (7.41–45.52), and the area under the SROC curve (AUC) was 0.8128. The pooled sensitivity and specificity of the LR-M criteria for OMs were 0.85 (0.81–0.88) and 0.86 (0.85–0.87), the DOR was 27.82 (11.83–65.40), respectively, and the SROC AUC was 0.9098.

Conclusion The CEUS LI-RADS can effectively distinguish HCC from other hepatic malignancy in high-risk patients based on LR-5 criteria and LR-M criteria. However, further studies are needed for validation due to the limited number of included studies and the potential heterogeneity among the included studies.

Zusammenfassung

Ziel Das kontrastverstärkte Ultraschall-Berichts- und Datensystem für die Leberbildgebung (CEUS-LI-RADS) des American College of Radiology (ACR), das diagnostische Kriterien für das hepatozelluläre Karzinom (HCC) und maligne Lebererkrankungen (OM) beinhaltet, wird in der klinischen Praxis zunehmend eingesetzt. Diese Studie führte eine Metaanalyse durch, um die diagnostische Genauigkeit von CEUS-LI-RADS zur Differenzierung zwischen HCC und OM bei Hochrisikopatienten zu beurteilen.

Methoden PubMed, Embase (Ovid) und Cochrane (CENTRAL) wurden nach relevanten Studien durchsucht. Einbezogen wurden alle Studien, in denen der Prozentsatz von HCC und OM in den LI-RADS-Kategorien angegeben wurde. Random-effect-Modelle wurden verwendet, um die gepoolte Sensitivität und Spezifität, die diagnostische Odds Ratio (DOR) und die summierte Receiver-Operating-Characteristic (SROC)-Kurve zu berechnen.

Ergebnisse Acht Studien mit 4215 fokalen Leberläsionen wurden in die abschließende Analyse einbezogen. Die gepoolte Sensitivität der LR-5-Kriterien für das HCC betrug 0,71 (95 %-KI 0,69–0,72) und die gepoolte Spezifität 0,88 (0,85–0,91), die DOR 18,36 (7,41–45,52) und die AUC (Area Under the Curve) der SROC 0,8128. Die gepoolte Sensitivität der LR-M-Kriterien für OMs betrug 0,85 (0,81–0,88) und die gepoolte Spezifität 0,86 (0,85–0,87), die DOR 27,82 (11,83–65,40) und die SROC-AUC 0,9098.

Schlussfolgerung CEUS-LI-RADS kann ein HCC anhand von LR-5-Kriterien und LR-M-Kriterien wirksam von anderen malignen Lebererkrankungen bei Hochrisikopatienten unterscheiden. Aufgrund der begrenzten Anzahl der eingeschlossenen Studien und deren potenzieller Heterogenität sind jedoch weitere Studien zur Validierung erforderlich.

Key words

contrast-enhanced ultrasound (CEUS) - liver - liver imaging reporting and data system (LI-RADS) - hepatocellular carcinoma (HCC)

Publication History

Received: 29 April 2020

Accepted: 03 November 2020

Article published online:
11 December 2020

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