Liver Imaging Reporting and Data System with MR Imaging: Evaluation in Nodules 20 mm or Smaller Detected in XXXX at Screening US.

@entity1 @entity82 @entity5 @entity1419 @entity3 @entity157
UNASSIGNED: Purpose To evaluate the diagnostic accuracy of the Liver Imaging Reporting and Data System (LI-RADS) with magnetic resonance (MR) imaging for hepatic nodules 20 mm or smaller detected during ultrasonographic (US) surveillance in @entity1 with @entity82 . Materials and Methods Between November 2003 and January 2010, @entity1 with @entity82 with a newly US-detected solitary hepatic nodule 20 mm or smaller were included in this institutional ethics committee-approved study. All @entity1 provided written informed consent before the study; the need to obtain consent for reanalysis of the data was waived. @entity1 underwent MR imaging and fine-needle biopsy (the reference standard). Nodules without pathologic confirmation were followed up with MR imaging every 6 months. A LI-RADS category was retrospectively assigned to nodules seen at MR imaging. The diagnostic accuracy for each LI-RADS category was described by sensitivity, specificity, and positive and negative predictive values with 95% confidence intervals. Results Final diagnoses of 133 nodules in 159 @entity1 were as follows: 102 @entity157 ( @entity157 ), three @entity1419 ( @entity1419 ), one neuroendocrine @entity3 , and 27 benign lesions (median MR imaging follow-up, 95 months). None (0%) of five LI-RADS category 1 lesions, three (25%) of 12 category 2 lesions, 29 (69%) of 42 category 3 lesions, 24 (96%) of 25 category 4 lesions, and 44 (98%) of 45 category 5 lesions were @entity157 . One category 3 lesion was ICC, one category 5 lesion was a neuroendocrine @entity3 , and two (50%) of four lesions categorized as other @entity5 were @entity157 . In @entity1 with nodules detected at surveillance US, LI-RADS category 4 criteria were as effective as category 5 criteria for @entity157 diagnosis. Combining both categories would improve sensitivity without impairing specificity or positive or negative predictive value for @entity157 diagnosis (42.3%, 98.2%, 97.8%, and 47.4% vs 65.4%, 96.4%, 97.1%, and 59.6%, respectively). Conclusion In @entity1 with @entity82 with US-detected nodules 20 mm or smaller, both LI-RADS category 4 and category 5 have high specificity for @entity157 . In addition, a relevant proportion of lesions categorized as LI-RADS category 2 or 3 or as other @entity5 were @entity157 . Thus, active diagnostic work-up, including biopsy to allow prompt treatment, is recommended in such @entity1 . (  ) RSNA, 2015 Online supplemental material is available for this article.
