%A Li,Jiawu
%A Ling,Wenwu
%A Chen,Shuang
%A Yang,Lulu
%A Ma,Lin
%A Lu,Qiang
%A Luo,Yan
%D 2021
%J Frontiers in Oncology
%C
%F
%G English
%K contrast-enhanced ultrasound,Liver imaging reporting and data system,Liver,Hepatocellular Carcinoma,ultrasound elastography
%Q
%R 10.3389/fonc.2021.662680
%W
%L
%M
%P
%7
%8 2021-April-30
%9 Original Research
%+ Yan Luo,Department of Ultrasound, West China Hospital, Sichuan University,China,luo_yan777@163.com
%#
%! Can risk stratification of background liver by LSM assist CEUS LI-RADS in the diagnosis of HCC?
%*
%<
%T Can Risk Stratification Based on Ultrasound Elastography of Background Liver Assist CEUS LI-RADS in the Diagnosis of HCC?
%U https://www.frontiersin.org/articles/10.3389/fonc.2021.662680
%V 11
%0 JOURNAL ARTICLE
%@ 2234-943X
%X ObjectiveTo explore whether risk stratification based on ultrasound elastography of liver background assists contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) in diagnosing HCC.Materials and MethodsIn total, 304 patients with focal liver lesions (FLLs) confirmed by pathology underwent CEUS and ultrasound elastography were included in this retrospective study. Patients with chronic hepatitis B (CHB, n=193) and non-CHB (n=111) were stratified by four liver stiffness measurement (LSM) thresholds. A LI-RADS category was assigned to FLLs using CEUS LI-RADS v2017. The diagnostic performance was assessed with the AUC, sensitivity, specificity, PPV, and NPV.ResultsThe mean background liver stiffness of HCC patients with CHB, HCC patients without CHB and non-HCC patients without CHB were 9.72 kPa, 8.23 kPa and 4.97 kPa, respectively. The AUC, sensitivity, specificity and PPV of CEUS LI-RADS for HCC in CHB patients with LSM ≥ 5.8 kPa, ≥ 6.8 kPa, ≥ 9.1 kPa, and ≥ 10.3 kPa were high, with corresponding values of 0.745 to 0.880, 94.2% to 95.3%, 81.3% to 85.7%, and 98.1% to 98.8%, respectively. Higher AUC and specificity for HCC was observed in non-CHB patients with LSM ≥ 9.1 kPa and ≥ 10.3 kPa compared to non-CHB patients with LSM ≥ 5.8 kPa and ≥ 6.8 kPa, with corresponding values of0.964/1.000 vs 0.590/0.580, and 100%/100% vs 60%/70%, respectively.ConclusionCEUS LI-RADS has a good diagnostic performance in CHB patients regardless of the background liver stiffness. Furthermore, CEUS LI-RADS can be applied for non-CHB patients with a LSM ≥ 9.1 kPa.