Abstract
AimTo determine inter-reader agreement in categorization of imaging features using the Liver Imaging Reporting and Data System (LI-RADS) treatment response (LR-TR) algorithm in patients with hepatocellular carcinoma (HCC) treated with conventional transarterial chemoembolization (cTACE).MethodsTwo radiologists used the LR-TR algorithm to assess 112 computed tomography (CT) examinations of 102 patients treated with cTACE. The inter-observer agreement in categorization of LR-TR features was assessed using kappa (κ) statistics.ResultsThere was substantial inter-observer agreement between the two reviewers using the LR-TR algorithm (κ = 0.70; 95% CI 0.58–0.81). The two reviewers categorized tumors as non-viable in 37 (33.0%) and 39 (34.8%) of 112 examinations, viable in 58 (51.8%) and 62 (55.4%) examinations, and equivocal in 18 (16.1%) and 11 (9.8%) examinations, respectively. There was almost perfect inter-observer agreement for the LR-TR non-viable category (κ = 0.80; 95% CI 0.68–0.92), substantial agreement for the viable category (κ = 0.78 95% CI 0.67–0.90), and fair agreement for the equivocal category (κ = 0.25; 95% CI 0.02–0.49).ConclusionThe LR-TR algorithm conveys high degrees of inter-observer agreement for the assessment of CT imaging features in the viable and non-viable categories. Further refinement of indeterminate features may be necessary to improve the correct categorization of equivocal lesions.Graphic abstract
Highlights
Materials and methodsLocoregional treatments, including conventional transarterial chemoembolization, play an important role in the treatment of patients with unresectable hepatocellular carcinoma (HCC) [1, 2]
Several systems have been developed to date with the aim of standardizing the evaluation of treatment response, including the Liver Imaging Reporting and Data System (LI-RADS) treatment response (LR-TR) algorithm [6, 7]
For post-treatment computed tomography (CT) features, the highest agreement was observed for the presence of Arterial phase hyperenhancement (APHE) (κ = 0.79; 95% CI 0.67–0.90)
Summary
Materials and methodsLocoregional treatments, including conventional transarterial chemoembolization (cTACE), play an important role in the treatment of patients with unresectable hepatocellular carcinoma (HCC) [1, 2]. Treatment response can be evaluated using contrastenhanced imaging together with various currently available response algorithms [4, 5]. Several systems have been developed to date with the aim of standardizing the evaluation of treatment response, including the Liver Imaging Reporting and Data System (LI-RADS) treatment response (LR-TR) algorithm [6, 7]. This new HCC-specific response algorithm was introduced in 2018 and is designed to assess treatment response following locoregional therapies using computed tomography (CT) or magnetic resonance imaging (MRI) [8, 9]. The LR-TR algorithm aims to improve communication between health-care providers, facilitate patient care, and standardize evaluation of treatment response for clinical and research purposes
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