Combining serum AFP and CEUS LI-RADS for better diagnostic performance in Chinese high-risk patients

作者：Gong, Wushuang; Wu, Jiaqi; Wei, Hong; Jiang, Zhaopeng; Wan, Ming; Wu, Chengwei; Xue, Weili; Ma, Rao; Zhou, Xianli^*; Zhou, Hang^*

来源：Radiologia Medica, 2023, 128(4): 393-401.

DOI：10.1007/s11547-023-01614-9

• Ultrasonography
• Alpha-fetoprotein
• Contrast agent
• Hepatocellular carcinoma
• Diagnosis

PurposeTo evaluate and compare the diagnostic performance of revised contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System version by combining LR-M category and serum alpha-fetoprotein (AFP) under different cut-off values.Material and methodsThis retrospective study enrolled 152 high-risk patients with 152 histology-proven nodules. For revised LI-RADS, nodules in LR-M with different elevated AFP thresholds have been reclassified as the LR-5 category. The diagnostic performances of original and revised CEUS LI-RADS were evaluated and compared.ResultsTo compare with the original version, the sensitivity of revised LR-5 (adjusted with AFP value > 200 ng/ml or 400 ng/ml) for the diagnosis of hepatocellular carcinoma (HCC) improved from 52.5 to 69.2% or 65.0%, respectively (both p < 0.001) without compromising specificity (87.5% vs. 71.9% or 78.1%, respectively, both p > 0.05). For the diagnosis of non-HCC malignancy, the specificity of the LR-M after reclassification was improved (69.6% vs. 84.4% or 80.7%, respectively, both p < 0.001) with a non-significant sensitivity reduction (100.0 vs. 70.6% or 82.4%, respectively, both p > 0.05). After modification, the sensitivity of LR-5 also increased to 69.1% or 64.9% (both p < 0.001), while the specificity and PPV did not change (both p > 0.05) for larger nodules (> 20 mm).ConclusionThe diagnostic performance of CEUS LI-RADS can be further improved by reclassifying LR-M nodules with elevated AFP thresholds to LR-5.

• 单位
  哈尔滨医科大学