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. 2020 Nov 26;8(22):5589-5602.
doi: 10.12998/wjcc.v8.i22.5589.

Interobserver agreement for contrast-enhanced ultrasound of liver imaging reporting and data system: A systematic review and meta-analysis

Jun Li  1 , Ming Chen  1 , Zi-Jing Wang  1 , Shu-Gang Li  2 , Meng Jiang  3 , Long Shi  4 , Chun-Li Cao  1 , Tian Sang  1 , Xin-Wu Cui  5 , Christoph F Dietrich  6
Affiliations

Interobserver agreement for contrast-enhanced ultrasound of liver imaging reporting and data system: A systematic review and meta-analysis

Jun Li et al. World J Clin Cases. .

Abstract

Background: Hepatocellular carcinoma is the most common primary liver malignancy. From the results of previous studies, Liver Imaging Reporting and Data System (LI-RADS) on contrast-enhanced ultrasound (CEUS) has shown satisfactory diagnostic value. However, a unified conclusion on the interobserver stability of this innovative ultrasound imaging has not been determined. The present meta-analysis examined the interobserver agreement of CEUS LI-RADS to provide some reference for subsequent related research.

Aim: To evaluate the interobserver agreement of LI-RADS on CEUS and analyze the sources of heterogeneity between studies.

Methods: Relevant papers on the subject of interobserver agreement on CEUS LI-RADS published before March 1, 2020 in China and other countries were analyzed. The studies were filtered, and the diagnostic criteria were evaluated. The selected references were analyzed using the "meta" and "metafor" packages of R software version 3.6.2.

Results: Eight studies were ultimately included in the present analysis. Meta-analysis results revealed that the summary Kappa value of included studies was 0.76 [95% confidence interval, 0.67-0.83], which shows substantial agreement. Higgins I 2 statistics also confirmed the substantial heterogeneity (I 2 = 91.30%, 95% confidence interval, 85.3%-94.9%, P < 0.01). Meta-regression identified the variables, including the method of patient enrollment, method of consistency testing, and patient race, which explained the substantial study heterogeneity.

Conclusion: CEUS LI-RADS demonstrated overall substantial interobserver agreement, but heterogeneous results between studies were also obvious. Further clinical investigations should consider a modified recommendation about the experimental design.

Keywords: Contrast-enhanced ultrasound; Diagnosis; Interobserver agreement; Liver imaging reporting and data system; Meta-analysis; Systematic review.

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Conflict of interest statement

Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other co-authors who contributed their efforts in this manuscript.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Bias risk of the included studies (QUADAS 2 criteria). 1This is our study.
Figure 3
Figure 3
Forest plot of pooled interobserver agreement for Liver Imaging Reporting and Data System on contrast-enhanced ultrasound. 1This is our study. CI: Confidence interval.
Figure 4
Figure 4
Publication bias of the included studies.
See this image and copyright information in PMC

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References

    1. El-Serag HB. Hepatocellular carcinoma. N Engl J Med. 2011;365:1118–1127. - PubMed
    1. Chernyak V, Fowler KJ, Kamaya A, Kielar AZ, Elsayes KM, Bashir MR, Kono Y, Do RK, Mitchell DG, Singal AG, Tang A, Sirlin CB. Liver Imaging Reporting and Data System (LI-RADS) Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients. Radiology. 2018;289:816–830. - PMC - PubMed
    1. Wang JY, Feng SY, Yi AJ, Zhu D, Xu JW, Li J, Cui XW, Dietrich CF. Comparison of Contrast-Enhanced Ultrasound vs Contrast-Enhanced Magnetic Resonance Imaging for the Diagnosis of Focal Liver Lesions Using the Liver Imaging Reporting and Data System. Ultrasound Med Biol. 2020;46:1216–1223. - PubMed
    1. Lu DS, Yu NC, Raman SS, Limanond P, Lassman C, Murray K, Tong MJ, Amado RG, Busuttil RW. Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver. Radiology. 2005;234:954–960. - PubMed
    1. Bruix J, Sherman M American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53:1020–1022. - PMC - PubMed