Seung Soo Kim1, Jeong Ah Hwang2, Hyeong Cheol Shin2, Seo-Youn Choi3, Tae Wook Kang4, Sung Shick Jou2, Woong Hee Lee2, Suyeon Park5, Nam Hun Heo6. 1. Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Soonchunhyang6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 330-721, Republic of Korea. radiology2008@hanmail.net. 2. Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Soonchunhyang6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 330-721, Republic of Korea. 3. Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea. 4. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 5. Department of Biomedical Statistics, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea. 6. Clinical Trial Center, Soonchunhyang University Cheonan Hospital, Cheonan-si, Chungcheongnam-do, Republic of Korea.
Abstract
OBJECTIVES: To compare the sensitivity of Liver Imaging Reporting and Data System (LI-RADS) v2017 for diagnosis of hepatocellular carcinoma (HCC) using multiphasic computed tomography (CT) between patients with and without moderate to severe fatty liver (MSFL). METHODS: This retrospective study included a total of 106 high-risk patients with 112 pathologically proven HCCs who underwent multiphasic CT. Patients were classified as MSFL (24 men, 2 women; mean age, 59.5 years [range, 38-79 years]) and non-MSFL (64 men, 16 women; mean age, 62.9 years [range, 40-89 years]) groups according to unenhanced CT liver and spleen parenchymal attenuation. Two independent radiologists assigned LI-RADS categories and accessed HCC features on CT. Sensitivities for LR-5 assignment and frequencies of HCC features were compared between the two groups. RESULTS: Sensitivities of LR-5 assignment for diagnosing HCCs were not significantly different between MSFL and non-MSFL groups (65.4% [17/26] vs. 76.7% [66/86] for reviewer 1, p = 0.247; 73.1% [19/26] vs. 76.74% [66/86] for reviewer 2, p = 0.702). No significant differences in the frequencies of arterial hyperenhancement, washout, and capsule were observed between the two groups (96.2% [25/26] vs. 98.8% [85/86], p = 0.412; 80.8% [21/26] vs. 89.5% [77/86], p = 0.308; and 53.8% [14/26] vs. 57% [49/86], p = 0.778, respectively). CONCLUSIONS: LI-RADS v2017 using CT showed comparable sensitivity for diagnosing HCC regardless of MSFL. KEY POINTS: • Using LI-RADS v2017 with CT, diagnosis of HCC in patients with MSFL showed similar sensitivity to that in patients without MSFL. • Frequencies of major HCC features (arterial hyperenhancement, washout, and capsule) on CT between the MSFL and non-MSFL groups were not significantly different. • LI-RADS using CT may be feasible for diagnosing HCC in patients with fatty liver.
OBJECTIVES: To compare the sensitivity of Liver Imaging Reporting and Data System (LI-RADS) v2017 for diagnosis of hepatocellular carcinoma (HCC) using multiphasic computed tomography (CT) between patients with and without moderate to severe fatty liver (MSFL). METHODS: This retrospective study included a total of 106 high-risk patients with 112 pathologically proven HCCs who underwent multiphasic CT. Patients were classified as MSFL (24 men, 2 women; mean age, 59.5 years [range, 38-79 years]) and non-MSFL (64 men, 16 women; mean age, 62.9 years [range, 40-89 years]) groups according to unenhanced CT liver and spleen parenchymal attenuation. Two independent radiologists assigned LI-RADS categories and accessed HCC features on CT. Sensitivities for LR-5 assignment and frequencies of HCC features were compared between the two groups. RESULTS: Sensitivities of LR-5 assignment for diagnosing HCCs were not significantly different between MSFL and non-MSFL groups (65.4% [17/26] vs. 76.7% [66/86] for reviewer 1, p = 0.247; 73.1% [19/26] vs. 76.74% [66/86] for reviewer 2, p = 0.702). No significant differences in the frequencies of arterial hyperenhancement, washout, and capsule were observed between the two groups (96.2% [25/26] vs. 98.8% [85/86], p = 0.412; 80.8% [21/26] vs. 89.5% [77/86], p = 0.308; and 53.8% [14/26] vs. 57% [49/86], p = 0.778, respectively). CONCLUSIONS: LI-RADS v2017 using CT showed comparable sensitivity for diagnosing HCC regardless of MSFL. KEY POINTS: • Using LI-RADS v2017 with CT, diagnosis of HCC in patients with MSFL showed similar sensitivity to that in patients without MSFL. • Frequencies of major HCC features (arterial hyperenhancement, washout, and capsule) on CT between the MSFL and non-MSFL groups were not significantly different. • LI-RADS using CT may be feasible for diagnosing HCC in patients with fatty liver.
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