Diagnostic accuracy and inter-reader reliability of the MRI Liver Imaging Reporting and Data System (version 2018) risk stratification and management system

SA Journal of Radiology

Field Value
Title Diagnostic accuracy and inter-reader reliability of the MRI Liver Imaging Reporting and Data System (version 2018) risk stratification and management system
Creator Singh, Ranjit Wilson, Mitchell P. Manolea, Florin Ahmed, Bilal Fung, Christopher Receveur, Darryn Low, Gavin
Subject Primary health care; education liver; cirrhosis; hepatocellular carcinoma; magnetic resonance imaging; reliability; neoplasm
Description Background: Hepatocellular carcinoma (HCC) can be diagnosed non-invasively, provided certain imaging criteria are met. However, the recent Liver Imaging Reporting and Data System (LI-RADS) version 2018 has not been widely validated.Objectives: This study aimed to evaluate the diagnostic accuracy and reader reliability of the LI-RADS version 2018 lexicon amongst fellowship trained radiologists compared with an expert consensus reference standard.Method: This retrospective study was conducted between 2018 and 2020. A total of 50 contrast enhanced liver magnetic resonance imaging (MRI) studies evaluating focal liver observations in patients with cirrhosis, hepatitis B virus (HBV) or prior HCC were acquired. The standard of reference was a consensus review by three fellowship-trained radiologists. Diagnostic accuracy including sensitivity, specificity, positive predictive value (PPV), negative predictive values (NPV) and area under the curve (AUC) values were calculated per LI-RADS category for each reader. Kappa statistics were used to measure reader agreement.Results: Readers demonstrated excellent specificities (88% – 100%) and NPVs (85% – 100%) across all LI-RADS categories. Sensitivities were variable, ranging from 67% to 83% for LI-RADS 1, 29% to 43% for LI-RADS 2, 100% for LI-RADS 3, 70% to 80% for LI-RADS 4 and 80% to 84% for LI-RADS 5. Readers showed excellent accuracy for differentiating benign and malignant liver lesions with AUC values 0.90. Overall inter-reader agreement was ‘good’ (kappa = 0.76, p  0.001). Pairwise inter-reader agreement was ‘very good’ (kappa ≥ 0.90, p  0.001).Conclusion: The LI-RADS version 2018 demonstrates excellent specificity, NPV and AUC values for risk stratification of liver observations by radiologists. Liver Imaging Reporting and Data System can reliably differentiate benign from malignant lesions when used in conjunction with corresponding LI-RADS management recommendations.
Publisher AOSIS
Date 2022-05-19
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Qualitative research
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajr.v26i1.2386
Source South African Journal of Radiology; Vol 26, No 1 (2022); 6 pages 2078-6778 1027-202X
Language eng
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https://sajr.org.za/index.php/sajr/article/view/2386/3192 https://sajr.org.za/index.php/sajr/article/view/2386/3193 https://sajr.org.za/index.php/sajr/article/view/2386/3194 https://sajr.org.za/index.php/sajr/article/view/2386/3195
Coverage Canada — —
Rights Copyright (c) 2022 Ranjit Singh https://creativecommons.org/licenses/by/4.0