Scholarlink

Objectives <p>To compare the diagnostic performance of corresponding probability-based categories between LI-RADS v2018 and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) v2022.</p> Materials and methods <p>This retrospective multicenter study included treatment-naïve patients at risk of hepatocellular carcinoma (HCC) who underwent gadoxetic acid-enhanced MRI between January 2015 and June 2018. Four radiologists independently evaluated MRI and CT when available; observations were categorized according to both criteria. Reference standards were pathology or clinical diagnosis. Generalized estimating equations were used for lesion clustering.</p> Results <p>The study included 2237 patients (1666 men; mean age, 59 ± 11 years) with 2445 lesions. On MRI, LR-5 showed a higher positive predictive value (PPV) than KLCA-NCC “definite HCC” (93.9% vs. 91.7%, <i>p</i> &lt; 0.001). PPV was not different between LR-4 and KLCA-NCC “probable HCC” (68.2% vs. 64.1%, <i>p</i> = 0.141). HCC proportion was 13.2% in LR-3 and 40.8% in KLCA-NCC “indeterminate nodule” (<i>p</i> &lt; 0.001). In 1455 patients with 1590 lesions on CT, LR-5 and KLCA-NCC had comparable PPV (92.9% in each). PPV of KLCA-NCC “probable HCC” was higher than LR-4 (83.8% vs. 73.9%, <i>p</i> = 0.012). HCC proportion was 52.0% in LR-3 and 46.2% in KLCA-NCC “indeterminate nodule” (<i>p</i> = 0.001).</p> Conclusion <p>Both LI-RADS v2018 and KLCA-NCC v2022 demonstrated effective probability-based risk stratification, but corresponding probability categories were not interchangeable. On CT, category performance differed from MRI, highlighting the need for modality-specific refinement to improve diagnostic precision.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Do conceptually corresponding diagnostic categories in LI-RADS v2018 and KLCA-NCC v2022 demonstrate equivalent diagnostic performance for HCC?</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>Both systems demonstrated effective probability-based stratification, but corresponding categories were not equivalent, and the performance was modality-specific</i>.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>Corresponding categories are not interchangeable between the two systems. The heterogeneity within “probable HCC” and modality-specific performance differences suggest potential benefits from subcategorization and refinement of CT-specific criteria.</i></p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

LI-RADS v2018 versus KLCA-NCC v2022: comparison of probability-based HCC categories

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月26日

查看全文
  • Jeong Hee Yoon,
  • Eun Sun Lee,
  • Young Kon Kim,
  • Chang Hee Lee,
  • Jeong Woo Kim,
  • Won Chang,
  • Joon-Il Choi,
  • Beom Jin Park,
  • Jin-Young Choi,
  • Seung-seob Kim,
  • Jeong-Sik Yu,
  • Seong Jin Park,
  • Myung-Won You,
  • Myoung-jin Jang,
  • Hee Sun Park,
  • Jeong Min Lee

摘要

Objectives

To compare the diagnostic performance of corresponding probability-based categories between LI-RADS v2018 and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) v2022.

Materials and methods

This retrospective multicenter study included treatment-naïve patients at risk of hepatocellular carcinoma (HCC) who underwent gadoxetic acid-enhanced MRI between January 2015 and June 2018. Four radiologists independently evaluated MRI and CT when available; observations were categorized according to both criteria. Reference standards were pathology or clinical diagnosis. Generalized estimating equations were used for lesion clustering.

Results

The study included 2237 patients (1666 men; mean age, 59 ± 11 years) with 2445 lesions. On MRI, LR-5 showed a higher positive predictive value (PPV) than KLCA-NCC “definite HCC” (93.9% vs. 91.7%, p < 0.001). PPV was not different between LR-4 and KLCA-NCC “probable HCC” (68.2% vs. 64.1%, p = 0.141). HCC proportion was 13.2% in LR-3 and 40.8% in KLCA-NCC “indeterminate nodule” (p < 0.001). In 1455 patients with 1590 lesions on CT, LR-5 and KLCA-NCC had comparable PPV (92.9% in each). PPV of KLCA-NCC “probable HCC” was higher than LR-4 (83.8% vs. 73.9%, p = 0.012). HCC proportion was 52.0% in LR-3 and 46.2% in KLCA-NCC “indeterminate nodule” (p = 0.001).

Conclusion

Both LI-RADS v2018 and KLCA-NCC v2022 demonstrated effective probability-based risk stratification, but corresponding probability categories were not interchangeable. On CT, category performance differed from MRI, highlighting the need for modality-specific refinement to improve diagnostic precision.

Key Points

Question Do conceptually corresponding diagnostic categories in LI-RADS v2018 and KLCA-NCC v2022 demonstrate equivalent diagnostic performance for HCC?

Findings Both systems demonstrated effective probability-based stratification, but corresponding categories were not equivalent, and the performance was modality-specific.

Clinical relevance Corresponding categories are not interchangeable between the two systems. The heterogeneity within “probable HCC” and modality-specific performance differences suggest potential benefits from subcategorization and refinement of CT-specific criteria.

Graphical Abstract