Contrast‐Enhanced Ultrasound Liver Imaging Reporting and Data System for Diagnosing Hepatocellular Carcinoma: A Meta‐Analysis
July 28, 2020 — Liver International
Background and aims
Contrast‐enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI‐RADS) is a comprehensive system for standardizing CEUS at high risk for hepatocellular carcinoma (HCC). We performed a meta‐analysis to determine the diagnostic performance of the CEUS LR‐5 for HCC and the pooled proportions of HCCs in each CEUS LI‐RADS category.
We searched multiple databases for studies reporting the diagnostic accuracy of the CEUS LI‐RADS. Random‐effects model was used to determine summary estimates of the diagnostic performance of CEUS LR‐5 and the pooled proportions of HCCs in each CEUS LI‐RADS category. Risk of bias and concerns regarding applicability were evaluated with the Quality Assessment of Diagnostic Accuracy Studies‐2 tool.
Eleven studies were included in the final analysis, which consisted of 5535 observations with 3983 HCCs. The pooled per‐observation sensitivity and specificity of the CEUS LR‐5 for diagnosing HCC were 69% (95% confidence interval [CI], 64%–73%) and 92% (95% CI, 83%–96%), respectively. The pooled proportions of HCCs were 0% (95% CI, 0–0%) for LR‐1, 1% (95% CI, 0%–4%) for CEUS LR‐2, 26% (95% CI, 14%–39%) for CEUS LR‐3, 77% (95% CI, 68%–86%) for CEUS LR‐4, 97% (95% CI, 95%–98%) for CEUS LR‐5, 57% (95% CI, 44%–69%) for CEUS LR‐M, and 100% (95% CI, 93%–100%) for CEUS LR‐5V or TIV.
The CEUS LR‐5 category showed moderate sensitivity and high specificity for diagnosing HCC. The proportion of HCCs was higher in the higher CEUS LI‐RADS categories.
Authors: Jaeseung Shin, Sunyoung Lee, Heejin Bae, Yong Eun Chung, Jin‑Young Choi, Yong‐Min Huh, Mi‑Suk Park
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Read full text at: https://doi.org/10.1111/liv.14617