Characterization of liver nodules in patients with chronic liver disease by MRI: performance of the Liver Imaging Reporting and Data System (LI-RADS v.2018) scale and its comparison with the Likert scale

Radiol Med. 2020 Jan;125(1):15-23. doi: 10.1007/s11547-019-01092-y. Epub 2019 Oct 5.

Abstract

Objectives: To evaluate the performance of the LI-RADS v.2018 scale by comparing it with the Likert scale, in the characterization of liver lesions.

Methods: A total of 39 patients with chronic liver disease underwent MR examination for characterization of 44 liver lesions. Images were independently analyzed by two radiologists using the LI-RADS scale and by another two radiologists using the Likert scale. The reference standard used was either histopathological evaluation or a 4-year MRI follow-up. Receiver operating characteristic analysis was performed.

Results: The LI-RADS scale obtained an accuracy of 80%, a sensitivity of 72%, a specificity of 93%, a positive predictive value (PPV) of 93% and a negative predictive value (NPV) of 70%, while the Likert scale achieved an accuracy of 79%, a sensitivity of 73%, a specificity of 87%, a PPV of 89% and a NPV of 70%. The area under the curve (AUC) was 85% for the LI-RADS scale and 83% for the Likert scale. The inter-observer agreement was strong (k = 0.89) between the LI-RADS evaluators and moderate (k = 0.69) between the Likert evaluators.

Conclusions: There was no statistically significant difference between the performances of the two scales; nevertheless, we suggest that the LI-RADS scale be used, as it appeared more objective and consistent.

Keywords: Carcinoma, hepatocellular; Data interpretation, statistical; Early detection of cancer; Liver cirrhosis; Magnetic resonance imaging.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Humans
  • Liver / diagnostic imaging
  • Liver Cirrhosis / diagnostic imaging*
  • Liver Neoplasms / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Imaging / standards
  • Male
  • Middle Aged
  • Observer Variation
  • Precancerous Conditions / diagnostic imaging*
  • Predictive Value of Tests
  • ROC Curve
  • Reference Standards
  • Retrospective Studies
  • Sensitivity and Specificity
  • Ultrasonography