Contrast‐enhanced ultrasound liver imaging reporting and data system for diagnosing hepatocellular carcinoma: A meta‐analysis

• Published in: Liver international 2020-10, Vol.40 (10), p.2345-2352
• Main Authors: Shin, Jaeseung, Lee, Sunyoung, Bae, Heejin, Chung, Yong Eun, Choi, Jin‑Young, Huh, Yong‐Min, Park, Mi‑Suk
• Format: Article
• Language: English
• Subjects: Confidence intervals; diagnosis; Diagnostic software; Diagnostic systems; Hepatocellular carcinoma; Liver; Liver cancer; liver neoplasms; Meta-analysis; microbubbles; Quality assessment; Quality control; Sensitivity; sensitivity and specificity; Ultrasonic imaging; Ultrasound
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/liv.14617

Background & aims Contrast‐enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI‐RADS) is a comprehensive system for standardizing CEUS at high risk for hepatocellular carcinoma (HCC). We performed a meta‐analysis to determine the diagnostic performance of the CEUS LR‐5 for HCC and the pooled proportions of HCCs in each CEUS LI‐RADS category. Methods We searched multiple databases for studies reporting the diagnostic accuracy of the CEUS LI‐RADS. Random‐effects model was used to determine summary estimates of the diagnostic performance of CEUS LR‐5 and the pooled proportions of HCCs in each CEUS LI‐RADS category. Risk of bias and concerns regarding applicability were evaluated with the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. Results Eleven studies were included in the final analysis, which consisted of 5535 observations with 3983 HCCs. The pooled per‐observation sensitivity and specificity of the CEUS LR‐5 for diagnosing HCC were 69% (95% confidence interval [CI], 64%–73%) and 92% (95% CI, 83%–96%) respectively. The pooled proportions of HCCs were 0% (95% CI, 0‐0%) for LR‐1, 1% (95% CI, 0%–4%) for CEUS LR‐2, 26% (95% CI, 14%–39%) for CEUS LR‐3, 77% (95% CI, 68%–86%) for CEUS LR‐4, 97% (95% CI, 95%–98%) for CEUS LR‐5, 57% (95% CI, 44%–69%) for CEUS LR‐M and 100% (95% CI, 93%–100%) for CEUS LR‐5V or TIV. Conclusions The CEUS LR‐5 category showed moderate sensitivity and high specificity for diagnosing HCC. The proportion of HCCs was higher in the higher CEUS LI‐RADS categories.