Inter-observer agreement and accuracy of LI-RADS v2018 for differentiating tumor in vein from bland thrombus using gadoxetic acid-enhanced magnetic resonance imaging.

Purpose: To assess inter-observer agreement and accuracy of LI-RADS v2018 for differentiating tumor in vein (TIV) from bland thrombus on gadoxetic acid-enhanced magnetic resonance imaging (Gx-MRI). Secondarily, to determine whether a multi-feature model improves accuracy compared to LI-RADS. Methods...

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Publicado en:Abdominal Radiology Vol. 48; no. 8; pp. 2557 - 2570
Autores principales: Ichikawa, Shintaro, Sirlin, Claude B., Cunha, Guilherme Moura, Wolfson, Tanya, Fowler, Kathryn J., Morisaka, Hiroyuki, Onohara, Kojiro, Shimizu, Tatsuya, Omiya, Yoshie, Sugiyama, Hiroki, Okumura, Akihiro, Onishi, Hiroshi
Formato: Journal Article
Publicado: Springer Nature Aug2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00261-023-03964-4
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        atl: Inter-observer agreement and accuracy of LI-RADS v2018 for differentiating tumor in vein from bland thrombus using gadoxetic acid-enhanced magnetic resonance imaging.
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        au:
          Ichikawa, Shintaro
          Sirlin, Claude B.
          Cunha, Guilherme Moura
          Wolfson, Tanya
          Fowler, Kathryn J.
          Morisaka, Hiroyuki
          Onohara, Kojiro
          Shimizu, Tatsuya
          Omiya, Yoshie
          Sugiyama, Hiroki
          Okumura, Akihiro
          Onishi, Hiroshi
        affil: Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, 431-3192, Hamamatsu, Shizuoka, Japan
      sug:
      ab: Purpose: To assess inter-observer agreement and accuracy of LI-RADS v2018 for differentiating tumor in vein (TIV) from bland thrombus on gadoxetic acid-enhanced magnetic resonance imaging (Gx-MRI). Secondarily, to determine whether a multi-feature model improves accuracy compared to LI-RADS. Methods: We retrospectively identified consecutive patients at risk for hepatocellular carcinoma with venous occlusion(s) reported on Gx-MRI. Five radiologists independently classified each occlusion as TIV or bland thrombus using the LI-RADS TIV criterion (enhancing soft tissue in vein). They also evaluated imaging features suggestive of TIV or bland thrombus. Intra-class correlation coefficient (ICC) was calculated for individual features. A multi-feature model was developed based on consensus scores of features with > 5% consensus prevalence and > 0.40 ICC. Sensitivity and specificity of the LI-RADS criterion and of the cross-validated multi-feature model were compared. Results: Ninety-eight patients with 103 venous occlusions (58 TIV, 45 bland thrombus) were included. The LI-RADS criterion provided 0.63 ICC and, depending on the reader, 0.62–0.93 sensitivity and 0.87–1.00 specificity. Five other features had > 5% consensus prevalence and > 0.40 ICC, including three LI-RADS suggestive features and two non-LI-RADS features. The optimal multi-feature model incorporated the LI-RADS criterion and one LI-RADS suggestive feature (occluded or obscured vein contiguous with malignant parenchymal mass). After cross-validation, the multi-feature model did not improve sensitivity or specificity compared to the LI-RADS criterion (P = 0.23 and 0.25, respectively). Conclusion: Using Gx-MRI, the LI-RADS criterion for TIV provides substantial inter-observer agreement, variable sensitivity, and high specificity for differentiating TIV from bland thrombus. A cross-validated multi-feature model did not improve diagnostic performance.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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