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ECR 2019 / C-3707
CT/MRI LI-RADSv2018: inter-reader agreement and correlation with pathology
Congress: ECR 2019
Poster No.: C-3707
Type: Scientific Exhibit
Keywords: Abdomen, Liver, Oncology, CT, MR, MR-Diffusion/Perfusion, Staging, Structured reporting, Observer performance, Cancer, Neoplasia, Pathology
Authors: A. Borgheresi, A. Agostini, D. Nicolini, R. Montalti, M. Vivarelli, A. Lorenzoni, A. Giovagnoni; Ancona/IT


Patient Demographics and Lesion characteristics

Ninety-two patients (median age: 64 y.o.; interquartile range: 56-72 y.o.) were included. Among the 92 patients, chronic liver etiology was due to HCV in 33 patients (pts), to HBV in 14 pts, to Alcohol in 14 pts and related to miscellaneous etiology in 31 patients. 

A total of 112 lesions (median diameter: 22 mm; interquartile range: 10–43 mm) were evaluated respectively in 63 CT and 49 MRI. At pathological evaluation, 44 lesions had E-S Grade 1 (G1), 48 lesions had G2, and 20 were G3. MVI was detected in 35 lesions ( Table 1 ). 

At radiological revision LI-RADSv2018 categories of LR-3, LR-4, LR-5, and LR-M were assigned. Imaging and pathological findings are summarized in Table 2.


Pathological correlation

Significant correlations were demonstrated between LR-5 and G2 and for LR-M with G3 and MIV ( Table 3 ). 

Table 4 summarizes significant correlation between LI-RADSv2018 Major and Ancillary Features with pathology. Tumor size, Corona enhancement, Mosaic architecture, Targetoid mass and Rim Arterial Phase Enhancement (APHE) were significantly related to the presence of MIV. Targetoid Mass, Rim APHE, and infiltrative appearance were significantly correlated to G3 ( Table 4 ).


Inter-reader agreement

LI-RADS score built on Major Features only showed a moderate IRA in CT (ICC=0.594) and in MRI (ICC=0.578); IRA for the final LI-RADS category was moderate in CT (ICC=0.723) and in MRI (ICC=0.689) ( Table 5 ). 


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