Per-Feature Accuracy of Liver Imaging Reporting and Data System Locoregional Treatment Response Algorithm: A Systematic Review and Meta-Analysis

• Published in: Cancers Vol. 13; no. 17; p. 4432
• Main Authors: Huh, Yeon Jong, Kim, Dong Hwan, Kim, Bohyun, Choi, Joon-Il, Rha, Sung Eun
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 02.09.2021; MDPI
• Subjects: Ablation; Accuracy; Algorithms; Computed tomography; Hepatocellular carcinoma; Liver diseases; Magnetic resonance imaging; Meta-analysis; Patients; Statistical analysis; Systematic Review
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13174432

We aimed to investigate the accuracy of each imaging feature of LI-RADS treatment response (LR-TR) viable category for diagnosing tumor viability of locoregional therapy (LRT)-treated HCC. Studies evaluating the per feature accuracy of the LR-TR viable category on dynamic contrast-enhanced CT or MRI were identified in databases. A bivariate random-effects model was used to calculate the pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of LR-TR viable features. Ten studies assessing the accuracies of LR-TR viable features (1153 treated observations in 971 patients) were included. The pooled sensitivities and specificities for diagnosing viable HCC were 81% (95% confidence interval [CI], 63–92%) and 95% (95% CI, 88–98%) for nodular, mass-like, or irregular thick tissue (NMLIT) with arterial phase hyperenhancement (APHE), 55% (95% CI, 34–75%) and 96% (95% CI, 94–98%) for NMLIT with washout appearance, and 21% (95% CI, 6–53%) and 98% (95% CI, 92–100%) for NMLIT with enhancement similar to pretreatment, respectively. Of these features, APHE showed the highest pooled DOR (81 [95% CI, 25–261]), followed by washout appearance (32 [95% CI, 13–82]) and enhancement similar to pretreatment (14 [95% CI, 5–39]). In conclusion, APHE provided the highest sensitivity and DOR for diagnosing viable HCC following LRT, while enhancement similar to pretreatment showed suboptimal performance.