Longitudinal evolution of CT and MRI LI-RADS v2014 category 1, 2, 3, and 4 observations

• Published in: European radiology 2019-09, Vol.29 (9), p.5073-5081
• Main Authors: Hong, Cheng William, Park, Charlie C., Mamidipalli, Adrija, Hooker, Jonathan C., Fazeli Dehkordy, Soudabeh, Igarashi, Saya, Alhumayed, Mohanad, Kono, Yuko, Loomba, Rohit, Wolfson, Tanya, Gamst, Anthony, Murphy, Paul, Sirlin, Claude B.
• Format: Article
• Language: English
• Subjects: Carcinoma, Hepatocellular - diagnosis; Categories; Classification; Clinical medicine; Computed tomography; Contrast agents; Diagnostic Radiology; Disease Progression; Female; Hepatobiliary-Pancreas; Humans; Imaging; Internal Medicine; Interventional Radiology; Liver; Liver - diagnostic imaging; Liver cancer; Liver Neoplasms - diagnosis; Longitudinal studies; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Malignancy; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Multidetector Computed Tomography - methods; Natural history; Neuroradiology; Radiology; Rank tests; Reagents; Resampling; Retrospective Studies; Risk; ROC Curve; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-019-06058-2

Objectives This study assesses the risk of progression of Liver Imaging Reporting and Data System (LI-RADS) categories, and the effects of inter-exam changes in modality or radiologist on LI-RADS categorization. Methods Clinical LI-RADS v2014 CT and MRI exams at our institution between January 2014 and September 2017 were retrospectively identified. Untreated LR-1, LR-2, LR-3, and LR-4 observations with at least one follow-up exam were included. Three hundred and seventy-two observations in 214 patients (149 male, 65 female, mean age 61 ± 10 years) were included during the study period (715 exams total). Cumulative incidence curves for progression to malignant LI-RADS categories (LR-5 or LR-M) and to LR-4 or higher were generated for each index category and compared using log-rank tests with a resampling extension. Relationships between inter-exam changes in LI-RADS category and modality or radiologist, adjusted for inter-exam time intervals, were modeled using mixed effect logistic regressions. Results Median inter-exam follow-up interval and total follow-up duration were 123 and 227 days, respectively. Index LR-1, LR-2, LR-3, and LR-4 differed significantly in their cumulative incidences of progression to malignant categories ( p