Modified LR-5 criteria based on gadoxetic acid can improve the sensitivity in the diagnosis of hepatocellular carcinoma  

作　　者：Yan Song Yue-Yue Zhang Qin Yu Rui Ma Yue Xiao Jun-Kang Shen Chao-Gang Wei 

机构地区：[1]Department of Radiology,Jieshou City People's Hospital(Jieshou Hospital Affiliated to Anhui Medical College),Fuyang 236500,Anhui Province,China [2]Department of Radiology,The Second Affiliated Hospital of Soochow University,Suzhou 215123,Jiangsu Province,China [3]Department of Radiology,Dongtai City People's Hospital,Yancheng 224200,Jiangsu Province,China [4]Department of Dialysis Center,Jieshou City People's Hospital(Jieshou Hospital Affiliated to Anhui Medical College),Fuyang 236500,Anhui Province,China [5]Department of Intensive Care Unit,Jieshou City People's Hospital(Jieshou Hospital Affiliated to Anhui Medical College),Fuyang 236500,Anhui Province,China

出　　处：《World Journal of Radiology》2025年第3期17-30,共14页世界放射学杂志(英文)

基　　金：This study was approved by the Medical Ethics Committee of Jieshou City People's Hospital,approval No.[2022]21.

摘　　要：BACKGROUND Currently,only tumors classified as LR-5 are considered definitive hepatocellular carcinoma(HCC),and no further pathologic confirmation is required to initiate therapy.Previous studies have shown that the sensitivity of LR-5 is modest,and lesions enhanced by gadoxetic acid(Gd-EOB-DTPA)may exhibit lower sensitivity than those enhanced by Gd-DTPA.AIM To identify malignant ancillary features(AFs)that can independently and significantly predict HCC in Liver Imaging Reporting and Data System version 2018,and to develop modified LR-5 criteria to improve diagnostic performance on Gd-EOB-DTPA-enhanced magnetic resonance imaging.METHODS Imaging data from patients with HCC risk factors who underwent abdominal Gd-EOB-DTPA-enhanced magnetic resonance imaging were collected.Univariate and multivariate logistic regression analyses were performed to determine AFs that could independently and significantly predict HCC.The modified LR-5 criteria involved reclassifying LR-4/LR-3 lesions based on major features combined with independently significant AFs for HCC,or by substituting threshold growth with significant AFs.McNemar's test was used to compare the diagnostic performance of the modified LR-5 criteria.RESULTS A total of 244 lesions from 216 patients were included.Transitional phase hypointensity,mild-moderate T2 hyperintensity,and fat in mass(more than adjacent liver)were identified as significant independent predictors of HCC.Using the modified LR-5 criteria(e.g.,LR-5-M1:LR-4+transitional phase hypointensity;LR-5-M4:LR-5 by transitional phase hypointensity instead of threshold growth;LR-5-M5:LR-5 by mild-moderate T2 hyperintensity instead of threshold growth;LR-5-M8:LR-3/LR-4+any two features of transitional phase hypointensity/mild-moderate T2 hyperintensity/fat in mass),sensitivities were significantly increased(88.5%-89.1%)compared to the standard LR-5(60.6%;all P values<0.05),while specificities(84.8%-89.9%)remained largely unchanged(93.7%;all P values>0.05).The LR-5-M8 criterion achieved the highest sensitiv

关 键 词：Hepatocellular carcinoma Liver Imaging Reporting and Data System Gadoxetic acid Sensitivity SPECIFICITY Modified Liver Imaging Reporting and Data System 

分 类 号：R73[医药卫生—肿瘤]