Can Modifications of LR‐M Criteria Improve the Diagnostic Performance of Contrast‐Enhanced Ultrasound LI‐RADS for Small Hepatic Lesions up to 3 cm?

Abstract

ObjectiveTo assess the diagnostic performance of the contrast‐enhanced ultrasound liver imaging reporting and data system (CEUS LI‐RADS) version 2017 for small hepatic lesions of ≤3 cm before and after changing the LR‐M criteria.MethodsWe retrospectively analyzed the CEUS examination of 179 patients who were at high risk of hepatocellular carcinoma (HCC) with focal hepatic lesions ≤3 cm (194 lesions in total) and evaluated the diagnostic capability of the American College of Radiology and modified CEUS LI‐RADS algorithms.ResultsRevision of the early washout time to 45 seconds increased the sensitivity of LR‐5 in predicting HCC (P = .004), with no significant decrease in specificity (P = .118). It also made better the specificity of LR‐M in predicting non‐HCC malignancies (P = .001), with no significant decrease in sensitivity (P = .094). However, using within 3 minutes as the criterion for marked washout time improved the LR‐5 sensitivity (P < .001) but decreased its specificity (P = .009) in predicting HCC, whereas the specificity of LR‐M in predicting non‐HCC malignancies increased (P < .001), but the sensitivity decreased (P = .027).ConclusionsCEUS LI‐RADS (v2017) is a valid method for predicting HCC risk in high‐risk patients. The diagnostic performance of LR‐5 and LR‐M could boost when the early washout time is revised to 45 seconds.