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Do Risk Factors for HCC Impact the Association of CT/MRI LIRADS Major Features With HCC? An Individual Participant Data Meta-Analysis

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机构： [1]Faculty of Medicine at The University of Ottawa, Ottawa, ON, Canada [2]Ottawa Hospital Research Institute, Ottawa, ON, Canada [3]Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada [4]Duke University School of Medicine, Durham, NC, USA [5]Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada [6]Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, NS, Canada [7]Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada [8]Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA [9]Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA [10]Liver Imaging Group, Department of Radiology, UC San Diego, La Jolla, CA, USA [11]Departments of Radiology and Medicine, Duke University Medical Center, Durham, NC, USA [12]Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC, USA [13]Department of Radiology, University of North Carolina, Chapel Hill, NC, USA [14]Department of Radiology, Centre Hospitalier de l’Universit de Montral, Montral, QC, Canada [15]Department of Radiology, College of Medicine, Taibah University, Medina, Saudi Arabia [16]Department of Radiology, King Faisal Specialist Hospital and Research Centre, Medina, Saudi Arabia [17]Department of Radiology, Duke University Medical Center, Durham, NC, USA [18]Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland [19]Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK [20]Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA [21]Centre de Recherche du Centre Hospitalier de l’Universit de Montral, Montreal, QC, Canada [22]Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China [23]Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea [24]Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China [25]Department of Radiology, Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea [26]Department of Radiology, Dong-A University Hospital, Dong-A University College of Medicine, Seogu, Busan, South Korea [27]Department of Radiology, Seoul National University Hospital, Seoul, South Korea [28]Weill Cornell Medical Center, New York, NY, USA [29]Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea [30]Department of Radiology, Hôpital Beaujon, APHP.Nord, Clichy & Université Paris Cité, CRI UMR 1149, Paris, France [31]2nd Radiology Department, Warsaw Medical University, Warsaw, Poland [32]Department of Radiology, Jeonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea [33]Rm c-159 Departments of Radiology and Epidemiology, University of Ottawa, Ottawa, ON, Canada

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关键词： LI-RADS CT/MRI HCC risk factors major features

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Background: Guidelines suggest the Liver Imaging Reporting and Data System (LI-RADS) may not be applicable for some populations at risk for hepatocellular carcinoma (HCC). However, data assessing the association of HCC risk factors with LI-RADS major features are lacking. Purpose: To evaluate whether the association between HCC risk factors and each CT/MRI LI-RADS major feature differs among individuals at-risk for HCC. Methods: Databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus) were searched from 2014 to 2022. Individual participant data (IPD) were extracted from studies evaluating HCC diagnosis using CT/MRI LI-RADS and reporting HCC risk factors. IPD from studies were pooled and modelled with one-stage meta-regressions. Interactions were assessed between major features and HCC risk factors, including age, sex, cirrhosis, chronic hepatitis B virus (HBV), and study location. A mixed effects model that included the major features, as well as separate models that included interactions between each risk factor and each major feature, were fit. Differences in interactions across levels of each risk factor were calculated using adjusted odds-ratios (ORs), 95% confidence-intervals (CI), and z-tests. Risk of bias was assessed using QUADAS-2. (Protocol: https://osf.io/tdv7j/). Results: Across 23 studies (2958 patients and 3553 observations), the associations between LI-RADS major features and HCC were consistent across several HCC risk factors (P-value range: .09-.99). A sensitivity analysis among the 4 studies with a low risk of bias did not differ from the primary analysis. Conclusion: The association between CT/MRI LI-RADS major features and HCC risk factors do not significantly differ in individuals at-risk for HCC. These findings suggest that CT/MR LI-RADS should be applied to all patients considered at risk by LI-RADS without modification or exclusions, regardless of the presence or absence of the risk factors evaluated in this study.

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大类 | 3 区医学

小类 | 3 区核医学

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第一作者机构： [1]Faculty of Medicine at The University of Ottawa, Ottawa, ON, Canada

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Do Risk Factors for HCC Impact the Association of CT/MRI LIRADS Major Features With HCC? An Individual Participant Data Meta-Analysis

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