Abstract
BackgroundThe Liver Imaging Reporting and Data System (LI-RADS) and European Association for the Study of the Liver (EASL) criteria are widely used for diagnosing hepatocellular carcinoma (HCC). Radiomics allows further quantitative tumor heterogeneity profiling. This study aimed to compare the diagnostic accuracies of the version 2018 (v2018) EASL, LI-RADS criteria and radiomics models for HCC in high-risk patients.MethodsEthical approval by the institutional review board and informed consent were obtained for this study. From July 2015 to September 2018, consecutive high-risk patients were enrolled in our tertiary care hospital and underwent gadoxetic acid-enhanced magnetic resonance (MR) imaging and subsequent hepatic surgery. We constructed a multi-sequence-based three-dimensional whole-tumor radiomics signature by least absolute shrinkage and selection operator model and multivariate logistic regression analysis. The diagnostic accuracies of the radiomics signature was validated in an independent cohort and compared with the EASL and LI-RADS criteria reviewed by two independent radiologists.ResultsTwo hundred twenty-nine pathologically confirmed nodules (173 HCCs, mean size: 5.74 ± 3.17 cm) in 211 patients were included. Among them, 201 patients (95%) were infected with hepatitis B virus (HBV). The sensitivity and specificity were 73 and 71% for the radiomics signature, 91 and 71% for the EASL criteria, and 86 and 82% for the LI-RADS criteria, respectively. The areas under the receiver operating characteristic curves (AUCs) of the radiomics signature (0.810), LI-RADS (0.841) and EASL criteria (0.811) were comparable.ConclusionsIn HBV-predominant high-risk patients, the multi-sequence-based MR radiomics signature, v2018 EASL and LI-RADS criteria demonstrated comparable overall accuracies for HCC.
Highlights
The LI-RADS Liver Imaging Reporting and Data System (Liver) Imaging Reporting and Data System (LI-RADS) and European Association for the Study of the Liver (EASL) criteria are widely used for diagnosing hepatocellular carcinoma (HCC)
A total of 173 nodules in 165 patients were proven as HCCs, 32 nodules in 30 patients as non-HCC malignancies, and the remaining 24 nodules in 16 patients as nonHCC benign lesions
We found that the multisequence-based magnetic resonance (MR) radiomics signature, the LI-RADS v2018 and the EASL v2018 demonstrated comparable diagnostic accuracies for HCC in high-risk patients
Summary
The Liver Imaging Reporting and Data System (LI-RADS) and European Association for the Study of the Liver (EASL) criteria are widely used for diagnosing hepatocellular carcinoma (HCC). With the advent of novel imaging techniques, HCC diagnostic criteria have been continuously updated to incorporate several new imaging features on various modalities, among which the European Association for the Study of the Liver (EASL) criteria have been widely considered as a reliable scheme [2]. Many of these criteria lack clear lexicons regarding modality-specific imaging features [2, 3]. LI-RADS is developed and modified based predominantly on Western data [2, 4], but the demand for validation of the system in Asian cohort remains vital
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