An assessment of liver lesions using a combination of CEUS LI-RADS and AFP
Chao-Qun Li, Hui Huang, Si-Min Ruan, Hang-Tong Hu, Meng-Fei Xian, Xiao-Yan Xie, Ming-de Lu, Ming Kuang, Ying Wang, Li-da Chen
Abdom Radiol (NY) . 2022 Apr;47(4):1311-1320. doi: 10.1007/s00261-022-03428-1. Epub 2022 Feb 5.
Purpose: To improve noninvasive diagnosis of HCC using a combination of CE US LI-RADS and alpha-fetoprotein (AFP).
Methods: 757 solitary liver nodules from 757 patients at risk of HCC with CE US and serum AFP test were categorized as LR-1 to LR-5 through LR-M according to CE US LI-RADS version 2017. In LR-3, LR-4, and LR-M nodules, those with AFP > 200 ng/ml were reclassified as mLR-5. Nodules with LR-5 and mLR-5 were reclassified as definitely HCC to modify CE US LI-RADS. Diagnostic performance was assessed with specificity, sensitivity, and PPV.
Results: The sensitivity, specificity, and PPV of LR-5 as a predictor of HCC were 64.7%, 97.8%, and 98.9%, respectively. 32.1% patients with solitary liver nodule had AFP greater than 200 ng/ml, of which 98.8% were HCC (25.8%, 7.5%, 2.5% assigned to LR-M, LR-4, LR-3, respectively) and 1.2% were Combined Hepatocellular Cholangiocarcinoma. After modification, the sensitivity increased to 79.6% (P < 0.001), while specificity and PPV remained high (96.6% and 98.7%, P > 0.050).
Conclusion: The combination of CE US LI-RADS and AFP for diagnosing HCC improved diagnostic sensitivity significantly, while maintaining high PPV and specificity in patients with the solitary liver nodule.
Read Full Article Here: https://doi.org/10.1007/s00261-022-03428-1