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LI-RADS ancillary feature prediction of longitudinal category changes in LR-3 observations: an exploratory study

  • Erin ShropshireEmail author
  • Adrija Mamidipalli
  • Tanya Wolfson
  • Brian C. Allen
  • Tracy A. Jaffe
  • Saya Igarashi
  • Atsushi Higaki
  • Masahiro Tanabe
  • Anthony Gamst
  • Claude B. Sirlin
  • Mustafa R. Bashir
Hepatobiliary
  • 10 Downloads

Abstract

Purpose

To determine whether LI-RADS ancillary features predict longitudinal LR-3 observation category changes.

Materials and Methods

This exploratory, retrospective, single-center study with an independent reading center included patients who underwent two or more multiphase CT or MRI examinations for hepatocellular carcinoma assessment between 2011 and 2015. Three readers independently evaluated each observation using CT/MRI LI-RADS v2017, and observations categorized LR-3 using major features only were included in the analysis. Prevalence of major and ancillary features was calculated. After excluding low-frequency (< 5%) features, inter-reader agreement was assessed using intraclass correlation coefficient (ICC). Major and ancillary feature prediction of observation upgrade (to LR-4 or higher) or downgrade (to LR-1 or LR-2) on follow-up imaging was assessed using logistic regression.

Results

141 LR-3 observations in 79 patients were included. Arterial phase hyperenhancement, washout, restricted diffusion, mild-moderate T2 hyperintensity, and hepatobiliary phase hypointensity were frequent enough for further analysis (consensus prevalence 5.0–66.0%). ICCs for inter-reader agreement ranged from 0.18 for restricted diffusion to 0.48 for hepatobiliary phase hypointensity. On follow-up, 40% (57/141) of baseline LR-3 observations remained LR-3. 8% (11/141) were downgraded to LR-2, and 42% (59/141) were downgraded to LR-1. A small number were ultimately upgraded to LR-4 (2%, 3/141) or LR-5 (8%, 11/141). None of the assessed major or ancillary features was significantly associated with observation category change. Longer follow-up time was significantly associated with both observation upgrade and downgrade.

Conclusion

While numerous ancillary features are described in LI-RADS, most are rarely present and are not useful predictors of LR-3 observation category changes.

Keywords

Hepatocellular carcinoma LI-RADS MRI 

Notes

Author contribution

ES: Primary author, data collection, analysis, and data manager. AM: Data collection, analysis, and manuscript revision. TW: Study design, statistical analysis, secondary author of statistical portion, and manuscript revision. BCA, TAJ: Data collection, study reader, and manuscript revision. SI, AH, MT: Study design, data collection, and manuscript revision. AG: Study design, statistical analysis, and manuscript revision. CBS: Study design, data collection, data analysis, and manuscript revision. MRB: Study design, study reader, data analysis, manuscript revision, and corresponding author.

Compliance with ethical standards

Disclosure

Erin Shropshire, Adrija Mamidipalli, Tanya Wolfson, Brian C. Allen, Tracy A. Jaffe, Saya Igarashi, Atsushi Higaki, Masahiro Tanabe, Anthony Gamst: No grants or assistance relevant to the study, no financial disclosures. Claude B. Sirlin: Research grants: Bayer, GE, Gilead, Philips, Siemens; Personal consulting: Boehringer, Epigenomics; Representative for institutional consultation: BMS, Exact Sciences, IBM-Watson; Active lab service agreements: Enanta, Gilead, ICON, Intercept, Nusirt, Shire, Synageva, Takeda; Completed lab service agreements: Alexion, AstraZeneca, Bristol-Myers Squibb, Celgene, Galmed, Genzyme, Isis, Janssen, Pfizer, Roche, Sanofi, Virtualscopics. Mustafa R. Bashir: Research Grants: Siemens Healthcare, NGM Biopharmaceuticals, Madrigal Pharmaceuticals, Metacrine Inc., ProSciento Inc., Pinnacle Clinical Research, CymaBay Therapeutics; Consulting: MedPace.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Erin Shropshire
    • 1
    Email author
  • Adrija Mamidipalli
    • 2
  • Tanya Wolfson
    • 3
  • Brian C. Allen
    • 1
  • Tracy A. Jaffe
    • 1
  • Saya Igarashi
    • 2
    • 4
  • Atsushi Higaki
    • 2
    • 5
  • Masahiro Tanabe
    • 2
    • 6
  • Anthony Gamst
    • 3
  • Claude B. Sirlin
    • 2
  • Mustafa R. Bashir
    • 1
  1. 1.Department of RadiologyDuke University Medical CenterDurhamUSA
  2. 2.Liver Imaging Group, Department of RadiologyUniversity of California, San DiegoSan DiegoUSA
  3. 3.Computational and Applied Statistics Laboratory (CASL), San Diego Supercomputer CenterUniversity of California, San DiegoLa JollaUSA
  4. 4.Department of RadiologyKanazawa University Graduate School of Medical ScienceKanazawaJapan
  5. 5.Department of RadiologyKawasaki Medical SchoolOkayamaJapan
  6. 6.Department of RadiologyYamaguchi University Graduate School of MedicineYamaguchiJapan

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