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01-08-2019 | Ultrasound

Comparison between M-score and LR-M in the reporting system of contrast-enhanced ultrasound LI-RADS

Authors: Li-Da Chen, Si-Min Ruan, Yuan Lin, Jin-Yu Liang, Shun-Li Shen, Hang-Tong Hu, Yang Huang, Wei Li, Zhu Wang, Xiao-Yan Xie, Ming-De Lu, Ming Kuang, Wei Wang

Published in: European Radiology | Issue 8/2019

Abstract

Objective

To develop a contrast-enhanced ultrasound (CEUS) M-score and compare it with LR-M in CEUS Liver Imaging Reporting and Data System (LI-RADS).

Methods

We retrospectively enrolled 105 consecutive high-risk patients with hepatocellular carcinoma (HCC) and 105 with intrahepatic cholangiocarcinoma (ICC). The subjects were selected by propensity score matching between November 2003 and December 2017. A CEUS M-score for predicting ICC was constructed based on specific CEUS features by the least absolute shrinkage and selection operator regularised regression. M-score was used to develop a modified CEUS LI-RADS. The diagnostic performance of the modified CEUS LI-RADS using M-score for diagnosing HCC and ICC was compared with American College of Radiology (ACR) CEUS LI-RADS using LR-M.

Results

The most useful features for ICC were as follows: poorly circumscribed (69.52%), rim enhancement (63.81%), early washout (92.38%), intratumoural vein (56.19%), obscure boundary of intratumoural non-enhanced area (57.14%), and marked washout (59.05%, all p < 0.001). For predicting ICC, the M-score had a higher specificity (88.57% vs. 63.81%) with lower sensitivity (89.52% vs. 95.24%) compared with LR-M. For diagnosing HCC, the sensitivity of modified LI-RADS (80.95%) was much higher than that of ACR LI-RADS (57.14%), but the specificity was lower (90.48% vs. 96.19%). The area under the curve (AUC) of modified LI-RADS (0.857) was much higher than that of ACR LI-RADS (0.767, p = 0.0001). The modified positive predictive value (PPV) of ACR LI-RADS and modified LI-RADS were 99.42% and 98.99%, respectively.

Conclusions

The modified LI-RADS with M-score had higher sensitivity for diagnosing HCC and higher specificity for diagnosing ICC than ACR LI-RADS.

Key Points

• For predicting ICC, the M-score had a higher specificity (88.57% vs. 63.81%) with lower sensitivity (89.52% vs. 95.24%) compared with LR-M.

• A CEUS M-score for predicting ICC consisted of more detailed CEUS features (poorly circumscribed, rim enhancement, early washout, intratumoural vein, obscure boundary of intratumoural non-enhanced area, and marked washout) was constructed.

• For diagnosing HCC, the sensitivity of modified LI-RADS (80.95%) was much higher than that of ACR LI-RADS (57.14%), but the specificity was lower (90.48% vs. 96.19%). The modified positive predictive value (PPV) of ACR LI-RADS and modified LI-RADS were 99.42% and 98.99%, respectively.

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Title: Comparison between M-score and LR-M in the reporting system of contrast-enhanced ultrasound LI-RADS
Authors: Li-Da Chen
Si-Min Ruan
Yuan Lin
Jin-Yu Liang
Shun-Li Shen
Hang-Tong Hu
Yang Huang
Wei Li
Zhu Wang
Xiao-Yan Xie
Ming-De Lu
Ming Kuang
Wei Wang
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 8/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5927-8

At a glance: The STEP trials

Springer Medicine

Comparison between M-score and LR-M in the reporting system of contrast-enhanced ultrasound LI-RADS

Abstract

Objective

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Key Points

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