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LI-RADS ancillary feature prediction of longitudinal category changes in LR-3 observations: an exploratory study.
Abdominal Radiology ( IF 2.4 ) Pub Date : 2020-02-12 , DOI: 10.1007/s00261-020-02429-2
Erin Shropshire 1 , Adrija Mamidipalli 2 , Tanya Wolfson 3 , Brian C Allen 1 , Tracy A Jaffe 1 , Saya Igarashi 2, 4 , Atsushi Higaki 2, 5 , Masahiro Tanabe 2, 6 , Anthony Gamst 3 , Claude B Sirlin 2 , Mustafa R Bashir 1
Affiliation  

Purpose

To determine whether LI-RADS ancillary features predict longitudinal LR-3 observation category changes.

Materials and Methods

This exploratory, retrospective, single-center study with an independent reading center included patients who underwent two or more multiphase CT or MRI examinations for hepatocellular carcinoma assessment between 2011 and 2015. Three readers independently evaluated each observation using CT/MRI LI-RADS v2017, and observations categorized LR-3 using major features only were included in the analysis. Prevalence of major and ancillary features was calculated. After excluding low-frequency (< 5%) features, inter-reader agreement was assessed using intraclass correlation coefficient (ICC). Major and ancillary feature prediction of observation upgrade (to LR-4 or higher) or downgrade (to LR-1 or LR-2) on follow-up imaging was assessed using logistic regression.

Results

141 LR-3 observations in 79 patients were included. Arterial phase hyperenhancement, washout, restricted diffusion, mild-moderate T2 hyperintensity, and hepatobiliary phase hypointensity were frequent enough for further analysis (consensus prevalence 5.0–66.0%). ICCs for inter-reader agreement ranged from 0.18 for restricted diffusion to 0.48 for hepatobiliary phase hypointensity. On follow-up, 40% (57/141) of baseline LR-3 observations remained LR-3. 8% (11/141) were downgraded to LR-2, and 42% (59/141) were downgraded to LR-1. A small number were ultimately upgraded to LR-4 (2%, 3/141) or LR-5 (8%, 11/141). None of the assessed major or ancillary features was significantly associated with observation category change. Longer follow-up time was significantly associated with both observation upgrade and downgrade.

Conclusion

While numerous ancillary features are described in LI-RADS, most are rarely present and are not useful predictors of LR-3 observation category changes.



中文翻译:

LR-3 观测中纵向类别变化的 LI-RADS 辅助特征预测:一项探索性研究。

目的

确定 LI-RADS 辅助特征是否预测纵向 LR-3 观察类别变化。

材料和方法

这项具有独立阅读中心的探索性、回顾性、单中心研究纳入了在 2011 年至 2015 年期间接受两次或多次多期 CT 或 MRI 检查以评估肝细胞癌的患者。三名读者使用 CT/MRI LI-RADS v2017 独立评估每个观察结果,分析中包括仅使用主要特征对 LR-3 进行分类的观察结果。计算主要和辅助特征的患病率。在排除低频 (< 5%) 特征后,使用类内相关系数 (ICC) 评估读者间的一致性。使用逻辑回归评估随访成像中观察升级(至 LR-4 或更高)或降级(至 LR-1 或 LR-2)的主要和辅助特征预测。

结果

包括 79 名患者的 141 项 LR-3 观察结果。动脉期高信号、洗脱、弥散受限、轻中度 T2 高信号和肝胆期低信号的频率足以进行进一步分析(共识患病率为 5.0-66.0%)。读者间一致性的 ICC 范围从限制扩散的 0.18 到肝胆期低信号的 0.48。在随访中,40% (57/141) 的基线 LR-3 观察结果仍然是 LR-3。8% (11/141) 被降级为 LR-2,42% (59/141) 被降级为 LR-1。少数最终升级为 LR-4(2%,3/141)或 LR-5(8%,11/141)。评估的主要或辅助特征均与观察类别变化无显着关联。更长的随访时间与观察升级和降级显着相关。

结论

虽然 LI-RADS 中描述了许多辅助特征,但大多数很少出现,并且不是 LR-3 观察类别变化的有用预测因子。

更新日期:2020-02-12
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