Inter-Reader Agreement for CT and MRI LI-RADS Version 2018: An Individual Participant Data Meta-Analysis.
Publication/Presentation Date
8-7-2026
Abstract
BACKGROUND: The Liver Imaging Reporting and Data System (LI-RADS) is a classification system to diagnose hepatocellular carcinoma (HCC) noninvasively. The reported LI-RADS inter-reader variability in single-center studies highlights the need to better understand the variability on a broader scale.
PURPOSE: Evaluate inter-reader agreement for LI-RADS CT/MRI v2018 categorization and imaging features using individual participant data (IPD) meta-analysis for MRI and CT separately.
STUDY TYPE: Retrospective meta-analysis.
POPULATION: 805 patients (542 male, mean age 60.8 ± 11.6 [SD] years) at risk of HCC.
FIELD STRENGTH/SEQUENCE: 1.5 and 3 T, Sequences varied across institutions but followed standard LI-RADS protocols.
ASSESSMENT: Studies from the LI-RADS Living IPD Meta-Analysis Project were used.
INCLUSION CRITERIA: observations evaluated by > 1 reader using LI-RADS CT/MRI v2018. Risk of bias was assessed for the index test domain using QUADAS-2; sensitivity analysis was conducted excluding high-risk observations. The developed protocol is available on the Open Science Framework (https://osf.io/tdv7j/files/6kh7s).
STATISTICAL TESTS: A two-step meta-analytic approach was used to determine pooled kappa (κ) with heterogeneity assessed using τ
RESULTS: Five studies (three CT and MRI, two MRI) comprising 975 observations were included. Four studies had two readers, and one had three, most readers were specialized abdominal radiologists (3-33 years' experience). Inter-reader agreement (κ) for major features was 0.21-0.74 on MRI and 0.11-0.75 on CT. For Ancillary features, κ was -0.02 to 0.68 for MRI and -0.02 to 0.58 on CT, and LR-M agreement was -0.07 to 0.58 on MRI and -0.07 to 0.66 on CT. LI-RADS categorization showed agreement of κ = 0.76 for MRI and κ = 0.50 for CT.
DATA CONCLUSION: MRI consistently reported higher agreement than CT for shared features, but overall inter-reader agreement was variable.
EVIDENCE LEVEL: 3.
TECHNICAL EFFICACY: Stage 2: diagnostic accuracy, considered by most as clinical efficacy.
ISSN
1522-2586
Published In/Presented At
Das, S., Lam, E., Muhn, O., Mahbub, S., Ansari, D., Osman, H., Awad, R., Al-Ghita, M. K., Thornhill, R., Walsh, C., Leeflang, M. M. G., Naringrekar, H., van der Pol, C. B., Alabousi, M., Bashir, M. R., Costa, A. F., Levis, B., Salameh, J., Kang, H., Clarke, C., … McInnes, M. D. F. (2026). Inter-Reader Agreement for CT and MRI LI-RADS Version 2018: An Individual Participant Data Meta-Analysis. Journal of magnetic resonance imaging : JMRI, 10.1002/jmri.70467. Advance online publication. https://doi.org/10.1002/jmri.70467
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
42563623
Department(s)
Administration and Leadership
Document Type
Article