Is concurrent LR-5 associated with a higher rate of hepatocellular carcinoma in LR-3 or LR-4 observations? An individual participant data meta-analysis.
Publication/Presentation Date
4-1-2025
Abstract
BACKGROUND: The Liver Imaging Reporting and Data System (LI-RADS) does not consider factors extrinsic to the observation of interest, such as concurrent LR-5 observations.
PURPOSE: To evaluate whether the presence of a concurrent LR-5 observation is associated with a difference in the probability that LR-3 or LR-4 observations represent hepatocellular carcinoma (HCC) through an individual participant data (IPD) meta-analysis.
METHODS: Multiple databases were searched from 1/2014 to 2/2023 for studies evaluating the diagnostic accuracy of CT/MRI for HCC using LI-RADS v2014/2017/2018. The search strategy, study selection, and data collection process can be found at https://osf.io/rpg8x . Using a generalized linear mixed model (GLMM), IPD were pooled across studies and modeled simultaneously with a one-stage meta-analysis approach to estimate positive predictive value (PPV) of LR-3 and LR-4 observations without and with concurrent LR-5 for the diagnosis of HCC. Risk of bias was assessed using a composite reference standard and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2).
RESULTS: Twenty-nine studies comprising 2591 observations in 1456 patients (mean age 59 years, 1083 [74%] male) were included. 587/1960 (29.9%) LR-3 observations in 1009 patients had concurrent LR-5. The PPV for LR-3 observations with concurrent LR-5 was not significantly different from the PPV without LR-5 (45.4% vs 37.1%, p = 0.63). 264/631 (41.8%) LR-4 observations in 447 patients had concurrent LR-5. The PPV for LR-4 observations with concurrent LR-5 was not significantly different from LR-4 observations without concurrent LR-5 (88.6% vs 69.5%, p = 0.08). A sensitivity analysis for low-risk of bias studies (n = 9) did not differ from the primary analysis.
CONCLUSION: The presence of concurrent LR-5 was not significantly associated with differences in PPV for HCC in LR-3 or LR-4 observations, supporting the current LI-RADS paradigm, wherein the presence of synchronous LR-5 may not alter the categorization of LR-3 and LR-4 observations.
Volume
50
Issue
4
First Page
1533
Last Page
1546
ISSN
2366-0058
Published In/Presented At
Abedrabbo, N., Lerner, E., Lam, E., Kadi, D., Dawit, H., van der Pol, C., Salameh, J. P., Naringrekar, H., Adamo, R., Alabousi, M., Levis, B., Tang, A., Alhasan, A., Arvind, A., Singal, A., Allen, B., Bartnik, K., Podgórska, J., Furlan, A., Cannella, R., … Bashir, M. (2025). Is concurrent LR-5 associated with a higher rate of hepatocellular carcinoma in LR-3 or LR-4 observations? An individual participant data meta-analysis. Abdominal radiology (New York), 50(4), 1533–1546. https://doi.org/10.1007/s00261-024-04580-6
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
39333410
Department(s)
Administration and Leadership
Document Type
Article