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DOI: 10.1055/a-1979-0808
Response to Letter to the Editor Regarding the Article “Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in Diagnosing Hepatocellular Carcinoma: Diagnostic Performance and Interobserver Agreement” by Zhou and Collaborators
The low diagnostic prediction capacity of CEUS LR-M class for a specific tumor is not a problem but rather perhaps an advantageThanks Stefanini and your colleagues for positive comments on our recent study of applying CEUS LI-RADS in eastern countries with emphasis on diagnostic performance and interobserver agreement [1]. We agree that the specificity of CEUS LR-5 is high enough (range:92.7–100.0 % in cirrhotic patients in our study) to rule out non-hepatocellular carcinoma(HCC) lesions. And we also agree that inconsistency of interpreting objective CEUS features, especially ancillary features, significantly hinder the general application of CEUS LI-RADS in targeted high-risk population. Even after years of CEUS LI-RADS learning and training, ancillary features are still deemed as failure to make additional value in final decision. Therefore, we fully approve removing current ancillary features (mosaic and nodule-in-nodule pattern) from CEUS LI-RADS workup as Stefanini demonstrated.
Publication History
Article published online:
19 April 2023
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References
- 1 Zhou H, Zhang C, Du L. et al. Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in Diagnosing Hepatocellular Carcinoma: Diagnostic Performance and Interobserver Agreement. Ultraschall in der Medizin (Stuttgart, Germany: 1980) 2022; 43: 64-71 DOI: 10.1055/a-1168-6321.
- 2 Ding J, Long L, Zhang X. et al. Contrast-enhanced ultrasound LI-RADS 2017: comparison with CT/MRI LI-RADS. European radiology 2021; 31: 847-854 DOI: 10.1007/s00330-020-07159-z.
- 3 Huang JY, Li JW, Lu Q. et al. Diagnostic Accuracy of CEUS LI-RADS for the Characterization of Liver Nodules 20 mm or Smaller in Patients at Risk for Hepatocellular Carcinoma. Radiology 2020; 294: 329-339 DOI: 10.1148/radiol.2019191086.
- 4 Shin J, Lee S, Hwang JA. et al. MRI-diagnosis of category LR-M observations in the Liver Imaging Reporting and Data System v2018: a systematic review and meta-analysis. European radiology 2022; 32: 3319-3326 DOI: 10.1007/s00330-021-08382-y.
- 5 Zhou H, Sun J, Jiang T. et al. A Nomogram Based on Combining Clinical Features and Contrast Enhanced Ultrasound LI-RADS Improves Prediction of Microvascular Invasion in Hepatocellular Carcinoma. Frontiers in oncology 2021; 11: 699290 DOI: 10.3389/fonc.2021.699290.
- 6 Ding J, Qin Z, Zhou Y. et al. Impact of Revision of the LR-M Criteria on the Diagnostic Performance of Contrast-Enhanced Ultrasound LI-RADS. Ultrasound in medicine & biology 2021; 47: 3403-3410 DOI: 10.1016/j.ultrasmedbio.2021.08.007.
- 7 Li CQ, Huang H, Ruan SM. et al. An assessment of liver lesions using a combination of CEUS LI-RADS and AFP. Abdominal radiology (New York) 2022; 47: 1311-1320 DOI: 10.1007/s00261-022-03428-1.
- 8 Feng Y, Qin XC, Luo Y. et al. Efficacy of contrast-enhanced ultrasound washout rate in predicting hepatocellular carcinoma differentiation. Ultrasound in medicine & biology 2015; 41: 1553-1560 DOI: 10.1016/j.ultrasmedbio.2015.01.026.