Diagnostic Performance Of Version 2018 LI-RADS Hepatobiliary Phase Hypointensity For Hepatocellular Carcinoma

Objective: To investigate the effect of Gd-EOB-DTPA enhanced MR images hepatobiliary phase hypointensity on the diagnostic efficacy of the version 2018 of LI-RADS in s at high-risk patients.Material and methods:This retrospective study was performed on 159 high-risk patients and 179 hepatic nodules who received Gd-EOB-DTPA enhanced MR images examination in Department of radiology,Affiliated Hospital of Guilin Medical University from January 2014 to December 2020.The two radiologists double-blindly review and analyze patient’t images,recorded the major features(observation size、arterial phase hyperenhancement、enhancing “capsule”、onperipheral “washout” and threshold growth)and ancillary features(hepatobiliary phase hypointensity,HBP)for each observation,and categorized based on the version 2018 of LI-RADS diagnostic table.The diagnostic performance of major and ancillary features and LI-RADS category were analyzed statistically.Results: The sensitivity,specificity and accuracy of the two radiologists in diagnosing based on enhancing “capsule” were 85.71%、77.78%、84.92% and 86.96%、77.78%、86.03%,and the positive predictive value was 97.18%、97.22%,respectively.The sensitivity,specificity and accuracy based on onperipheral “washout” were 89.44%、88.89%、89.39% and 90.06%、94.44%、90.50%,respectively,and the positive predictive value was over 98%.The sensitivity,specificity and accuracy based on arterial phase hyperenhancement were 85.09%、33.33%、79.89%,respectively,and the positive predictive value was 91.95%.The sensitivity,specificity and accuracy of the two radiologists in diagnosing based on hepatobiliary phase hypointensity were99.38%、77.78% and 97.21%,respectively,and the positive predictive value was97.56%.The sensitivity,specificity and accuracy of the two radiologists in diagnosing as LR-5 were 82%、83.33%、82.12%,and the positive predictive value was 97.78%,LR-4/5 were 94.41%、61.11%、91.06% and the positive predictive value were 95.60%.The sensitivity,specificity,accuracy and positive predictive value of the two radiologists in diagnosing s as LR-5、LR-4/5 based on new diagnostic model were 82%、83.33%、82.12%、97.78% and 99.38%、55.56%、94.97%、95.81%,when the hepatobiliary phase hypointensity was taken as the major features to adjust the LI-RADS category.Conclusions: The study shown that diagnostic performance of version 2018 LI-RADS demonstrated high sensitivity,specificity and accuracy of diagnosing in high-risk patients based on Gd-EOB-DTPA enhanced MR images.In the new diagnostic model based on the hepatobiliary phase hypointensity was taken as the major features to adjust the LI-RADS category,without significant reduction the specificity,hepatobiliary phase hypointensity can improve the diagnostic performance of LR-4、LR-4/5 for s HCC.