An assessment of liver lesions using a combination of CEUS LI-RADS and AFP

摘要

Abstract Purpose To improve noninvasive diagnosis of HCC using a combination of CE US LI-RADS and alpha-fetoprotein (AFP).Methods 757 solitary liver nodules from 757 patients at risk of HCC with CE US and serum AFP test were categorized as LR-1 to LR-5 through LR-M according to CE US LI-RADS version 2017. In LR-3, LR-4, and LR-M nodules, those with AFP?>?200?ng/ml were reclassified as mLR-5. Nodules with LR-5 and mLR-5 were reclassified as definitely HCC to modify CE US LI-RADS. Diagnostic performance was assessed with specificity, sensitivity, and PPV.Results The sensitivity, specificity, and PPV of LR-5 as a predictor of HCC were 64.7, 97.8, and 98.9, respectively. 32.1 patients with solitary liver nodule had AFP greater than 200?ng/ml, of which 98.8 were HCC (25.8, 7.5, 2.5 assigned to LR-M, LR-4, LR-3, respectively) and 1.2 were Combined Hepatocellular Cholangiocarcinoma. After modification, the sensitivity increased to 79.6 (P??0.050).Conclusion The combination of CE US LI-RADS and AFP for diagnosing HCC improved diagnostic sensitivity significantly, while maintaining high PPV and specificity in patients with the solitary liver nodule.Graphical abstract