The Liver Imaging Reporting and Data System tumor-in-vein category: a systematic review and meta-analysis
Objectives We aimed to systematically determine the etiology of the Liver Imaging Reporting and Data System (LI-RADS) tumor-in-vein category (LR-TIV) on contrast-enhanced CT or MRI and to determine the sources of heterogeneity between reported results. Methods Original studies reporting the etiology...
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Published in | European radiology Vol. 31; no. 4; pp. 2497 - 2506 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.04.2021
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Objectives
We aimed to systematically determine the etiology of the Liver Imaging Reporting and Data System (LI-RADS) tumor-in-vein category (LR-TIV) on contrast-enhanced CT or MRI and to determine the sources of heterogeneity between reported results.
Methods
Original studies reporting the etiology of LR-TIV were identified in MEDLINE and EMBASE up until July 7, 2020. The meta-analytic pooled percentages of HCC and non-HCC in LR-TIV were calculated. Subgroup analyses were performed according to the type of reference standard and the most common underlying liver disease. Meta-regression analysis was performed to explore study heterogeneity.
Results
Sixteen studies reported the etiology of a total of 150 LR-TIV, of which 98 (65%) were HCC and 52 (35%) were non-HCC. The meta-analytic pooled percentages of HCC and non-HCC in LR-TIV were 70.9% (95% confidence interval [CI], 55.7–82.5%;
I
2
= 59%) and 29.2% (95% CI, 17.5–44.4%;
I
2
= 59%), respectively. The meta-analytic pooled percentage of HCC was lower in studies using only pathology as a reference standard (67.1%; 95% CI, 49.3–81.1%), but higher in studies in which hepatitis C was the most common underlying liver disease (81.9%; 95% CI, 11.3–99.4%) than that in the total 16 studies. Study type (cohort study versus case-control study) was significantly associated with study heterogeneity (
p
= 0.04).
Conclusion
The most common etiology of LR-TIV was HCC. It might be important to understand the percentage of HCC and non-HCC in LR-TIV in consideration of the type of reference standard, geographic differences, and study design.
Key Points
• The most common etiology of Liver Imaging Reporting and Data System (LI-RADS) tumor-in-vein category (LR-TIV) was hepatocellular carcinoma (HCC).
• The percentage of HCC in LR-TIV was relatively low in studies using only pathology as a reference standard, but high in studies in which hepatitis C was the most common underlying liver disease.
• Study type was a factor significantly influencing study heterogeneity. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3 |
ISSN: | 0938-7994 1432-1084 |
DOI: | 10.1007/s00330-020-07282-x |