Diagnostic value of contrast-enhanced ultrasound liver imaging reporting and data system versus European CEUS guidelines for liver malignant tumors

Abstract

Objective To investigate the diagnostic value of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) and European CEUS guidelines for liver malignant tumors in high-risk patients with hepatocellular carcinoma (HCC). Methods The imaging data of 89 high-risk patients with suspected HCC treated in Shenzhen Third People's Hospital from August 2020 to January 2022 were retrospectively analyzed. They were 74 males and 15 females, and aged between 22 and 77 (50.8±11.3) years. Pathological diagnosis was used as the gold standard, and receiver operating characteristic (ROC) curve analysis was adopted to calculate the areas under the ROC curve (AUC) of CEUS LI-RADS and European CEUS guidlines. And the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CEUS LR-5+LR-M and European CEUS guidelines for diagnosing liver malignancies were calculated. Results Of the 92 lesions, 77 lesions were classified as LR-5+LR-M by CEUS, and 77 lesions were diagnosed liver malignant tumors by European CEUS guidelines, and 75 lesions were pathologically confirmed to be malignant tumors of the liver. The AUC values of CEUS LI-RADS and European CEUS guidelines were 0.875 and 0.797, respectively, through no statistical difference (Z=1.71, P=0.088). Taking LR-5 and LR-M lesions as positive results, the sensitivity, specificity and PPV, NPV and accuracy were 97.3% (95%CI: 90.7%~99.7%) and 94.7% (95%CI: 86.9%~98.5%, Chi-square=8.12, P=0.004), 76.5% (95%CI: 50.1%~93.2%) and 64.7% (95%CI: 38.3%~85.8%), 94.8% and 92.2%, 86.7% and 73.3%, and 93.5% (95%CI: 86.3%~97.6%) and 89.1% (95%CI: 80.9%~94.7%, Chi-square=20.63, P < 0.001) in CEUS LR-5+LR-M and European CEUS guidelines for diagnosing liver malignancies, respectively. Conclusion CEUS LI-RADS shows comparable diagnostic performance as European CEUS guidelines, but the sensitivity and accuracy of CEUS LI-RADS are significantly higher. [Key words] contrast-enhanced ultrasound , liver imaging reporting and data system , hepatocellular carcinoma, focal liver lesion , intrahepatic cholangiocarcinoma,

Keywords

• ontrast-enhanced ultrasound
• liver imaging reporting and data system
• hepatocellular carcinoma
• focal liver lesion
• intrahepatic cholangiocarcinoma