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Comparative Performance of 2018 LI-RADS versus Modified LIRADS (mLI-RADS): An Individual Participant Data Meta-Analysis

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机构： [1]Duke University School of Medicine, Durham, North Carolina, USA. [2]Department of Radiology, West China Hospital, Sichuan University, Chengdu, China. [3]Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada. [4]Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada. [5]Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. [6]Faculty of Medicine, The University of Ottawa, Ottawa, Ontario, Canada. [7]Departments of Radiology and Epidemiology uOttawa, The Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada. [8]Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada. [9]Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK. [10]Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. [11]Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA. [12]Department of Radiology, Sichuan University West China Hospital, Chengdu, Sichuan, China. [13]Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. [14]Weill Cornell Medical Center, New York City, New York, USA. [15]Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. [16]Department of Radiology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea. [17]Second Radiology Department, Warsaw Medical University, Warsaw, Poland. [18]Departments of Radiology and Medicine, Duke University Medical Center, Durham, North Carolina, USA. [19]Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, North Carolina, USA. [20]Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA.

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LI-RADS version 2018 (v2018) is used for non-invasive diagnosis of hepatocellular carcinoma (HCC). A recently proposed modification (known as mLI-RADS) demonstrated improved sensitivity while maintaining specificity and positive predictive value (PPV) of LI-RADS category 5 (definite HCC) for HCC. However, mLI-RADS requires multicenter validation.To evaluate the performance of v2018 and mLI-RADS for liver lesions in a large, heterogeneous, multi-national cohort of patients at risk for HCC.Systematic review and meta-analysis using individual participant data (IPD) [Study Protocol: https://osf.io/duys4].2223 observations from 1817 patients (includes all LI-RADS categories; females = 448, males = 1361, not reported = 8) at elevated risk for developing HCC (based on LI-RADS population criteria) from 12 retrospective studies.1.5T and 3T; complete liver MRI with gadoxetate disodium, including axial T2w images and dynamic axial fat-suppressed T1w images precontrast and in the arterial, portal venous, transitional, and hepatobiliary phases. Diffusion-weighted imaging was used when available.Liver observations were categorized using v2018 and mLI-RADS. The diagnostic performance of each system's category 5 (LR-5 and mLR-5) for HCC were compared.The Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2 was applied to determine risk of bias and applicability. Diagnostic performances were assessed using the likelihood ratio test for sensitivity and specificity and the Wald test for PPV. The significance level was P < 0.05.17% (2/12) of the studies were considered low risk of bias (244 liver observations; 164 patients). When compared to v2018, mLR-5 demonstrated higher sensitivity (61.3% vs. 46.5%, P < 0.001), similar PPV (85.3% vs. 86.3%, P = 0.89), and similar specificity (85.8% vs. 90.8%, P = 0.16) for HCC.This study confirms mLR-5 has higher sensitivity than LR-5 for HCC identification, while maintaining similar PPV and specificity, validating the mLI-RADS proposal in a heterogeneous, international cohort.3 TECHNICAL EFFICACY: Stage 2.© 2023 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.

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大类 | 2 区医学

小类 | 2 区核医学

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大类 | 2 区医学

小类 | 2 区核医学

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第一作者机构： [1]Duke University School of Medicine, Durham, North Carolina, USA.

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