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European Radiology
Published in: European Radiology 6/2018

01-06-2018 | Hepatobiliary-Pancreas

Does a combined CT and MRI protocol enhance the diagnostic efficacy of LI-RADS in the categorization of hepatic observations? A prospective comparative study

Authors: Mohammad Abd Alkhalik Basha, Mohamad Zakarya AlAzzazy, Ayman F. Ahmed, Hala Y. Yousef, Samar Mohamad Shehata, Dena Abd El Aziz El Sammak, Talaat Fathy, Ahmed Ali Obaya, Eman H. Abdelbary

Published in: European Radiology | Issue 6/2018

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Abstract

Objective

To compare diagnostic performance and agreement between CT, MRI and combined CT/MRI in reference to LI-RADS classification system to categorize hepatic observations detected in hepatic patients during screening ultrasound.

Methods

240 patients with 296 liver observations detected during ultrasound surveillance underwent hepatic CT and MRI examinations, histopathology, and clinical and radiological follow-up. Using LI-RADS v2014, six radiologists evaluated the observations independently and assigned a LI-RADS category to each observation using CT, MRI and combined CT/MRI.

Results

Combined CT and MRI in LI-RADS yielded better accuracy (91.29 %), sensitivity (90.71 %) and specificity (92.31 %) for hepatocellular carcinoma (HCC) diagnosis than using MRI or CT alone; accuracy, sensitivity and specificity decreased to 85.37 %, 86.34 %, and 83.65 %, respectively, for MRI and 67.6 %, 54.10 % and 91.35 %, respectively, for CT. The intraclass agreement of the LI-RADS scores between CT, MRI and combined CT/MRI was excellent (κ=0.9624 (95 % CI: 0.9318–0.9806)).

Conclusion

CT and MRI are complementary to each other. Combined CT/MRI enabled a more precise determination of LI-RADS category of hepatic observations; however, due to the expense and minor increase in accuracy, the combined methodology should only be utilized in cases of suspected HCC.

Key Points

• Hepatic observation may be categorized differently depending on the imaging modality used.
• We compared LI-RADS categorization between CT, MRI and combined CT/MRI.
• MRI produces higher accuracy and sensitivity, while CT produces higher specificity.
• Combining CT and MRI improves LIRADS categorization reports.
• Considering additional cost, combined methodology could be restricted to challenging cases.
Appendix
Available only for authorised users
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Metadata
Title
Does a combined CT and MRI protocol enhance the diagnostic efficacy of LI-RADS in the categorization of hepatic observations? A prospective comparative study
Authors
Mohammad Abd Alkhalik Basha
Mohamad Zakarya AlAzzazy
Ayman F. Ahmed
Hala Y. Yousef
Samar Mohamad Shehata
Dena Abd El Aziz El Sammak
Talaat Fathy
Ahmed Ali Obaya
Eman H. Abdelbary
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5232-y

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