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LI-RADS Version 2018 Targetoid Appearances on Gadoxetic Acid–Enhanced MRI: Interobserver Agreement and Diagnostic Performance for the Differentiation of HCC and Non-HCC Malignancy
DC Field | Value | Language |
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dc.contributor.author | Min, Ji Hye | - |
dc.contributor.author | Lee, Min Woo | - |
dc.contributor.author | Park, Hee Sun | - |
dc.contributor.author | Lee, Dong Ho | - |
dc.contributor.author | Park, Hyun Jeong | - |
dc.contributor.author | Lee, Ji Eun | - |
dc.contributor.author | Park, Sae-Jin | - |
dc.contributor.author | Kim, Seung-Seob | - |
dc.contributor.author | Park, Seung Hyun | - |
dc.contributor.author | Ha, Sang Yun | - |
dc.contributor.author | Hwang, Jeong Ah | - |
dc.contributor.author | Cha, Dong Ik | - |
dc.contributor.author | Park, Boram | - |
dc.date.accessioned | 2022-11-23T00:44:41Z | - |
dc.date.available | 2022-11-23T00:44:41Z | - |
dc.date.created | 2022-09-07 | - |
dc.date.issued | 2022-09 | - |
dc.identifier.citation | American Journal of Roentgenology, Vol.219 No.3, pp.421-433 | - |
dc.identifier.issn | 0361-803X | - |
dc.identifier.uri | https://hdl.handle.net/10371/187221 | - |
dc.description.abstract | © American Roentgen Ray Society.BACKGROUND. In LI-RADS version 2018, observations showing at least one of five targetoid appearances in different sequences or postcontrast phases are categorized LR-M, indicating likely non–hepatocellular carcinoma (HCC) malignancy. OBJECTIVE. The purpose of this study was to evaluate interobserver agreement for LI-RADS targetoid appearances among a large number of radiologists of varying experience and the diagnostic performance of targetoid appearances for differentiating HCC from non-HCC malignancy. METHODS. This retrospective study included 100 patients (76 men, 24 women; mean age, 58 ± 9 [SD] years) at high risk of HCC who underwent gadoxetic acid–enhanced MRI within 30 days before hepatic tumor resection (25 randomly included patients with non-HCC malignancy [13, intrahepatic cholangiocarcinoma; 12, combined HCC-cholangiocarcinoma]; 75 matched patients with HCC). Eight radiologists (four more experienced [8–15 years]; four less experienced [1–5 years]) from seven institutions independently assessed observations for the five targetoid appearances and LI-RADS categorization. Interobserver agreement and diagnostic performance for non-HCC malignancy were evaluated. RESULTS. Interobserver agreement was poor for peripheral washout (κ = 0.20); moderate for targetoid transitional phase or hepatobiliary phase appearance (κ = 0.33), delayed central enhancement (κ = 0.37), and targetoid restriction (κ = 0.43); and substantial for rim arterial phase hyperenhancement (κ = 0.61). Agreement was fair for at least one targetoid appearance (κ = 0.36) and moderate for at least two, three, or four targetoid appearances (κ = 0.43–0.51). Agreement for individual targetoid appearances was not significantly different between more experienced and less experienced readers other than for targetoid restriction (κ = 0.63 vs 0.43; p = .001). Agreement for at least one targetoid appearance was fair among more experienced (κ = 0.29) and less experienced (κ = 0.37) reviewers. Agreement for at least two, three, or four targetoid appearances was moderate to substantial among more experienced reviewers (κ = 0.45–0.63) and moderate among less experienced reviewers (κ = 0.42–0.56). Existing LR-M criteria of at least one targetoid appearance had median accuracy for non-HCC malignancy of 62%, sensitivity of 84%, and specificity of 54%. For all reviewers, accuracy was highest when at least three (median accuracy, 79%; sensitivity, 68%; specificity, 82%) or four (median accuracy, 80%; sensitivity, 54%; specificity, 88%) targetoid appearances were required. CONCLUSION. Targetoid appearances and LR-M categorization exhibited considerable interobserver variation among both more and less experienced reviewers. CLINICAL IMPACT. Requiring multiple targetoid appearances for LR-M categorization improved interobserver agreement and diagnostic accuracy for non-HCC malignancy. | - |
dc.language | 영어 | - |
dc.publisher | American Roentgen Ray Society | - |
dc.title | LI-RADS Version 2018 Targetoid Appearances on Gadoxetic Acid–Enhanced MRI: Interobserver Agreement and Diagnostic Performance for the Differentiation of HCC and Non-HCC Malignancy | - |
dc.type | Article | - |
dc.identifier.doi | 10.2214/AJR.22.27380 | - |
dc.citation.journaltitle | American Journal of Roentgenology | - |
dc.identifier.wosid | 000860840400013 | - |
dc.identifier.scopusid | 2-s2.0-85136693547 | - |
dc.citation.endpage | 433 | - |
dc.citation.number | 3 | - |
dc.citation.startpage | 421 | - |
dc.citation.volume | 219 | - |
dc.description.isOpenAccess | N | - |
dc.contributor.affiliatedAuthor | Lee, Dong Ho | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
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