#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Non-invasive diagnostic criteria of hepatocellular carcinoma: Comparison of diagnostic accuracy of updated LI-RADS with clinical practice guidelines of OPTN-UNOS, AASLD, NCCN, EASL-EORTC, and KLSCG-NCC


Autoři: Burcu Erkan aff001;  Jeffrey Meier aff001;  Toshimasa J. Clark aff001;  Jeffrey Kaplan aff002;  Jeffrey R. Lambert aff003;  Samuel Chang aff001
Působiště autorů: Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, United States of America aff001;  Department of Pathology, University of Colorado School of Medicine, Aurora, Colorado, United States of America aff002;  Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado, United States of America aff003
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226291

Souhrn

Purpose

To retrospectively compare the diagnostic performance of different noninvasive diagnostic criteria of HCC including LI-RADS, OPTN-UNOS, AASLD, NCCN, EASL-EORTC, KLCSG-NCC.

Materials and methods

We reviewed the medical records of 3,491 pathologically examined liver lesions from January-2011 to January-2015 in our institution. 195 lesions in 133 patients (M:F = 100:33) with chronic hepatitis B/C and/or cirrhosis for any etiology were finally included in our study, with 98 lesions ≥ 2 cm, 72 lesions between 1–2 cm, and 25 lesions < 1 cm. The main comparison was made with the largest nodules of each patient (n = 133). The lesions were retrospectively evaluated for the diagnosis of HCC on DCE-CT or MR using different noninvasive diagnostic criteria including LI-RADS, OPTN-UNOS, AASLD, NCCN, EASL-EORTC, and KLCSG-NCC. With pathological evaluation serving as a gold-standard, sensitivity, specificity, PPV and NPV as well as accuracy of the diagnostic criteria were calculated.

Results

There was no statistically significant differences in diagnostic accuracy among noninvasive diagnostic criteria. For 133 lesions of the largest lesion per patient, the overall accuracy was highest with LI-RADS criteria (89.3%) and the overall sensitivity was highest with LI-RADS, AASLD, NCCN criteria (all 89.5%). For 1–2 cm lesions, sensitivity decreased for all criteria in the following order: EASL-EORTC (59.1%), KLCSG-NCC (58.3%), LI-RADS, AASLD, NCCN (all 56.5%), and OPTN-UNOS (22.7%) criteria. OPTN-UNOS had the highest specificity in cirrhotic livers, 91.7%.

Conclusions

The current noninvasive diagnostic criteria of HCC have no statistically significant difference in diagnostic accuracy. Overall, LI-RADS had the highest sensitivity and accuracy among the guidelines. OPTN had the highest specificity for cirrhotic livers.

Klíčová slova:

Diagnostic medicine – Cirrhosis – Cancer detection and diagnosis – Diagnostic radiology – Lesions – Ultrasound imaging – Hepatocellular carcinoma – Biopsy


Zdroje

1. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. Journal of hepatology 2018;69(1):182–236. doi: 10.1016/j.jhep.2018.03.019 29628281

2. Mitchell DG, Bruix J, Sherman M, Sirlin CB. LI-RADS (Liver Imaging Reporting and Data System): summary, discussion, and consensus of the LI-RADS Management Working Group and future directions. Hepatology 2015;61(3):1056–1065. doi: 10.1002/hep.27304 25041904

3. Elsayes KM, Kielar AZ, Elmohr MM, Chernyak V, Masch WR, Furlan A, et al. White paper of the Society of Abdominal Radiology hepatocellular carcinoma diagnosis disease-focused panel on LI-RADS v2018 for CT and MRI. Abdom Radiol (NY) 2018;43(10):2625–2642. doi: 10.1007/s00261-018-1744-4 30155697

4. Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, Zhu AX, Murad MH, Marrero JA. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 2018;67(1):358–380. doi: 10.1002/hep.29086 28130846

5. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology 2011;53(3):1020–1022. doi: 10.1002/hep.24199 21374666

6. Lee JM, Park JW, Choi BI. 2014 KLCSG-NCC Korea Practice Guidelines for the management of hepatocellular carcinoma: HCC diagnostic algorithm. Dig Dis 2014;32(6):764–777. doi: 10.1159/000368020 25376295

7. Goodman ZD. Grading and staging systems for inflammation and fibrosis in chronic liver diseases. Journal of hepatology 2007;47(4):598–607. doi: 10.1016/j.jhep.2007.07.006 17692984

8. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer 2001;94(2):153–156. doi: 10.1002/ijc.1440 11668491

9. Akinyemiju T, Abera S, Ahmed M, Alam N, Alemayohu MA, Allen C,et al. The Burden of Primary Liver Cancer and Underlying Etiologies From 1990 to 2015 at the Global, Regional, and National Level: Results From the Global Burden of Disease Study 2015. JAMA oncology 2017;3(12):1683–1691. doi: 10.1001/jamaoncol.2017.3055 28983565

10. Terjung B, Lemnitzer I, Dumoulin FL, Effenberger W, Brackmann HH, Sauerbruch T, et al. Bleeding complications after percutaneous liver biopsy. An analysis of risk factors. Digestion 2003;67(3):138–145. doi: 10.1159/000071293 12853725

11. Carlin SP, Garcia-Botella A, Diez-Valladares L, Perez-Aguirre E, Ortega L, Mendez R, et al. Dissemination of hepatocellular carcinoma in subcutaeous tissue after fine needle aspiration cytology (FNAC). Hepato-gastroenterology 2013;60(128):1839–1840. 24719916

12. Rimola J, Forner A, Tremosini S, Reig M, Vilana R, Bianchi L,et al. Non-invasive diagnosis of hepatocellular carcinoma </ = 2 cm in cirrhosis. Diagnostic accuracy assessing fat, capsule and signal intensity at dynamic MRI. Journal of hepatology 2012;56(6):1317–1323. doi: 10.1016/j.jhep.2012.01.004 22314420

13. Kim SE, Lee HC, Shim JH, Park HJ, Kim KM, Kim PN, et al. Noninvasive diagnostic criteria for hepatocellular carcinoma in hepatic masses >2 cm in a hepatitis B virus-endemic area. Liver international: official journal of the International Association for the Study of the Liver 2011;31(10):1468–1476. doi: 10.1111/j.1478-3231.2011.02529.x 21745284

14. Park JW, An M, Choi JI, Kim YI, Kim SH, Lee WJ, et al. Accuracy of clinical criteria for the diagnosis of hepatocellular carcinoma without biopsy in a Hepatitis B virus-endemic area. Journal of cancer research and clinical oncology 2007;133(12):937–943. doi: 10.1007/s00432-007-0232-y 17516087

15. Forner A, Vilana R, Ayuso C, Bianchi L, Sole M, Ayuso JR, et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: Prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology 2008;47(1):97–104. doi: 10.1002/hep.21966 18069697

16. Bae SY, Choi MS, Gwak GY, Paik YH, Lee JH, Koh KC, et al. Comparison of usefulness of clinical diagnostic criteria for hepatocellular carcinoma in a hepatitis B endemic area. Clinical and molecular hepatology 2012;18(2):185–194. doi: 10.3350/cmh.2012.18.2.185 22893869

17. Ronot M, Fouque O, Esvan M, Lebigot J, Aubé C, Vilgrain V5. Comparison of the accuracy of AASLD and LI-RADS criteria for the non-invasive diagnosis of HCC smaller than 3 cm. J Hepatol. 2018 Apr;68(4):715–723. doi: 10.1016/j.jhep.2017.12.014 Epub 2017 Dec 21. 29274407


Článok vyšiel v časopise

PLOS One


2019 Číslo 12
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Aktuální možnosti diagnostiky a léčby litiáz
nový kurz
Autori: MUDr. Tomáš Ürge, PhD.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#