Evidence Supporting Diagnostic Value of Liver Imaging Reporting and Data System for CT- and MR Imaging-based Diagnosis of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis

Background: Based on the Liver Imaging Data and Reporting System (LI-RADS) guidelines, Hepatocellular Carcinoma (HCC) can be diagnosed using imaging criteria in patients at risk of HCC.Objective: This study aimed to assess the diagnostic value of LI-RADS in high-risk patients with HCC.Material and Methods: This systematic review is conducted on international databases, including Google Scholar, Web of Science, PubMed, Embase, PROQUEST, and Cochrane Library, with appropriate keywords. Using the binomial distribution formula, the variance of each study was calculated, and all the data were analyzed using STATA version ۱۶. The pooled sensitivity and specificity were determined using a random-effects meta-analysis approach. Also, we used the chi-squared test and I۲ index to calculate heterogeneity among studies, and Funnel plots and Egger tests were used for evaluating publication bias.Results: The pooled sensitivity was estimated at ۰.۸۰ (۹۵% CI: ۰.۷۶-۰.۸۴). According to different types of Liver Imaging Reporting and Data Systems (LI-RADS), the highest pooled sensitivity was in version ۲۰۱۸ (۰.۸۳ (۹۵% CI: ۰.۷۹-۰.۸۷) (I۲: ۸۰.۶%, P of chi ۲ test for heterogeneity: <۰.۰۰۱ and T۲: ۰.۰۰۱). The pooled specificity was estimated as ۰.۸۹ (۹۵% CI: ۰.۸۷-۰.۹۲). According to different types of LI-RADS, the highest pooled specificity was in version ۲۰۱۴ (۹۳.۰ (۹۵% CI: ۸۹.۰-۹۶.۰) (I۲: ۸۱.۷%, P of chi ۲ test for heterogeneity: <۰.۰۰۱ and T۲: ۰.۰۰۱).  Conclusion: LI-RADS can assist radiologists in achieving the required sensitivity and specificity in high-risk patients suspected to have HCC. Therefore, this strategy can serve as an appropriate tool for identifying HCC.

Keywords:

Carcinoma , Hepatocellular , Magnetic Resonance Imaging , CT , LI-RADS