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

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Title: Comparison between M-score and LR-M in the reporting system of contrast-enhanced ultrasound LI-RADS.
Authors: Chen, Li-Da1 (AUTHOR), Ruan, Si-Min1 (AUTHOR), Lin, Yuan2 (AUTHOR), Liang, Jin-Yu1 (AUTHOR), Shen, Shun-Li3 (AUTHOR), Hu, Hang-Tong1 (AUTHOR), Huang, Yang1 (AUTHOR), Li, Wei1 (AUTHOR), Wang, Zhu1 (AUTHOR), Xie, Xiao-Yan1 (AUTHOR), Lu, Ming-De1,3 (AUTHOR), Kuang, Ming1,3 (AUTHOR), Wang, Wei1 (AUTHOR) wangw73@mail.sysu.edu.cn
Source: European Radiology. Aug2019, Vol. 29 Issue 8, p4249-4257. 9p. 1 Black and White Photograph, 1 Diagram, 4 Charts, 1 Graph.
Subjects: American College of Radiology, Contrast-enhanced ultrasound, Propensity score matching, Hepatocellular carcinoma
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. [ABSTRACT FROM AUTHOR]
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Abstract:<bold>Objective: </bold>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).<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>The modified LI-RADS with M-score had higher sensitivity for diagnosing HCC and higher specificity for diagnosing ICC than ACR LI-RADS.<bold>Key Points: </bold>• 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. [ABSTRACT FROM AUTHOR]
ISSN:09387994
DOI:10.1007/s00330-018-5927-8