Interreader Reliability of Liver Imaging Reporting and Data System Treatment Response: A Systematic Review and Meta-Analysis.

Dong Wook Kim,Ji Sung Lee,So Yeon Kim,Sang Hyun Choi,So Jung Lee,Jae Ho Byun

doi:10.3390/diagnostics11020237

Abstract

Background: For a proper management strategy in patients with locoregionally treated hepatocellular carcinoma (HCC), it is essential that the Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (LR-TR) has high interreader reliability. We aimed to systematically evaluate the interreader reliability of LR-TR and sources of any study heterogeneity. Methods: Original studies reporting the interreader reliability of LR-TR were identified in MEDLINE and EMBASE up to 20 September 2020. The pooled kappa coefficient (κ) was calculated using the DerSimonian–Laird random effects model. Subgroup analyses were performed according to imaging modality (magnetic resonance imaging (MRI) or computed tomography (CT)). Meta-regression analyses were performed to explore study heterogeneity. Results: Eight studies with 851 HCCs were finally included. Pooled κ was 0.70 (95% CI, 0.58–0.82) for CT/MRI LR-TR, and those of MRI and CT were 0.71 (95% CI, 0.53–0.89) and 0.71 (95% CI, 0.65–0.78), respectively. Study design (p < 0.001) and type of treatment (p = 0.02) were significantly associated with substantial study heterogeneity. Conclusion: LR-TR showed substantial interreader reliability regardless of the imaging modality. Because of substantial study heterogeneity, which was significantly associated with study design and type of treatment, published values for the interreader reliability of LR-TR should be interpreted with care.

Highlights

Because of substantial study heterogeneity, which was significantly associated with study design and type of treatment, published values for the interreader reliability of LI-RADS treatment response algorithm (LR-TR) should be interpreted with care
The systematic search identified studies, and 104 wereeight screened after removal abstract, and six studies by 156 full-text reviews, studies were finall of 52 duplicates (Figure 1)
Our study found that the pooled interreader reliability of LR-TR was substantial (κ, 0.70; 95% CI, 0.58–0.82), and that the interreader reliability of computed tomography (CT) was very similar to that of magnetic resonance imaging (MRI) (CT, κ, 0.71 vs. MRI, κ, 0.71)

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. In the management of HCC, locoregional treatments, including local ablation, transarterial treatment, and external beam radiation therapy (EBRT), play major roles as curative, palliative, or bridging/downstaging therapies [3,4,5,6]. Multiphasic contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) are widely used to evaluate the response after locoregional treatment for HCC. Given the significant correlation between treatment response determined by CT or MRI and patient prognosis [7,8], the accurate and reliable assessment of treatment response by an imaging test cannot be overemphasized

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