Comparison Of Liver Imaging Reporting And Data System (LI-RADS) On Ultrasound And CT/MRI For Patients With Focal Liver Lesions

Objects:To evaluate the reliability of Liver Imaging Reporting and Data System(LI-RADS) on ultrasound in differentiating benign from malignant focal liver lesions, comparing to LI-RADS based on CT/ MRI.Materials and methods:Ninety-five patients who had chronic liver disease with 126 focal liver lesions were retrospectively enrolled in this study. All patients respectively underwent conventional ultrasound(US), contrast-enhanced US(CEUS) and dynamic contrast-enhanced computed tomography or magnetic resonance imaging(MRI) examinations, performed by one experienced US radiologist and one radiologist specialized in CT and MRI, who were totally blinded to the clinical data. According to LI-RADS developed by American College of Radiology and LI-RADS/US developed by Fujian Ultrasound Medical Engineering.LR1, 2 and 3 are considered as benign and LR4, 5 and LR-M considered as malignant. The sensitivity, specificity, overall accuracy, Youden Index and receiver operating characteristic(ROC) curves were produced. The Mc Nemar test was performed to determine the significance of any differences. Agreement of LI-RADS and LI-RADS/US was assessed by using kappa statistics. The area under the receiver operating characteristics curve(AUC) was used to assess the diagnostic values of the three methods. Parallel tests were used to calculate the sensitivity and specificity of LI-RADS combined with LI-RADS /US.Results: The sensitivity of CT/MRI?US and US+CEUS in differentiating be nign and maligant FLLs is 92.2%,78.4%,82.3%(p>0.05),respectively.The specificity of them is 89.3%,88.0%,93.3%(p>0.05),respectively.The Youden indenx are 81.5%,66.4%,75.7%.The AUC for three methods were calculated to be 0.959,0.904 and 0.948,respectively.CT/MRI has higher diagnositic accuracy than conventional US(p=0.045), whearas no difference is found between CT/MRI and US+CEUS.(p>0.05). Agreement for classification of lesions as benign versus malignant was moderate for LI-RADS and LI-RADS/US(?=0.651). The combination of LI-RADS and LI-RADS/US has a sensitivity of 99.2% and a specificity of 83.3%.Conclusion: No significant difference is observed between LI-RADS and LI-RADS/US in dfferentiating benign from maligant focal liver lesions. Agreement of LI-RADS and LI-RADS/Us for classification of focal liver lesions is moderate. CEUS can improve the diagnostic accuracy and combination of LI-RADS and LI-RADS/US can improve the diagnostic sensitivity in differentiating benign from malignant lesions.