Evidence map›Paper›PMID 39438285›Full record

ArticleAbdominal radiology (New York)2025

Combining CEUS and CT/MRI LI-RADS major imaging features: diagnostic accuracy for classification of indeterminate liver observations in patients at risk for HCC.

Tania Siu Xiao, Cristina Mariuxi Kuon Yeng Escalante, Aylin Tahmasebi, Yuko Kono, Fabio Piscaglia, Stephanie R Wilson, Alexandra Medellin-Kowalewski, Shuchi K Rodgers, Virginia Planz, Aya Kamaya and 9 more

Abstract readMulticenter Study
In one paragraph

Article in Abdominal radiology (New York), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Diagnostic Performance of PSMA PET/MRI in Characterizing LI-RADS 3 Observations in Patients with Cirrhosis.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Tania Siu XiaoDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
Cristina Mariuxi Kuon Yeng EscalanteDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
Aylin TahmasebiDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
Yuko KonoDivision of Gastroenterology and Hepatology, Department of Medicine, University of California, San Diego, USA.
Fabio PiscagliaDivision of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Stephanie R WilsonDepartment of Radiology, University of Calgary, Calgary, Canada.
Alexandra Medellin-KowalewskiDepartment of Radiology, University of Calgary, Calgary, Canada.
Shuchi K RodgersDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
Virginia PlanzDepartment of Radiology, Vanderbilt University, Nashville, USA.
Aya KamayaDepartment of Radiology, Stanford University, Stanford, USA.
David T FetzerDepartment of Radiology, UT Southwestern Medical Center, Dallas, USA.
Annalisa BerzigottiInselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Iuliana-Pompilia RaduInselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Paul S SidhuDepartment of Radiology, King's College Hospital, London, UK.
Corinne E WessnerDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
Kristen BradiganDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
John R EisenbreyDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
Flemming ForsbergDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
Andrej LyshchikDepartment of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA. andrej.lyshchik@jefferson.edu.

Funding

CONTRAST-ENHANCED ULTRASOUND EVALUATION OF FOCAL LIVER LESIONS IN PATIENTS WITH CIRRHOSIS OR OTHER RISK FACTORS FOR DEVELOPING HCCR01CA215520 · NCI · THOMAS JEFFERSON UNIVERSITY · PI LYSHCHIK, ANDREJ · 2017 to 2020
$2.4M
NCI NIH HHS R01 CA215520
6 · The paper itself

Abstract

purposeTo determine the diagnostic accuracy of combining CEUS and CT/MRI LI-RADS major imaging features for the improved categorization of liver observations indeterminate on both CT/MRI and CEUS. MATERIALS AND

methodsA retrospective analysis using a database from a prospective study conducted at 11 centers in North America and Europe from 2018 to 2022 included a total of 109 participants at risk for HCC who had liver observations with indeterminate characterization (LR3, LR-4, and LR-M) on both CEUS and CT/MRI. The individual CEUS and CT/MRI LI-RADS major features were extracted from the original study and analyzed in various combinations. Reference standards included biopsy, explant histology, and follow-up CT/MRI. The diagnostic performance of the combinations of LI-RADS major features for definitive diagnosis of HCC was calculated. A reverse, stepwise logistical regression sub-analysis was also performed.

resultsThis study included 114 observations indeterminate on both CT/MRI and CEUS. These observations were categorized as LR-3 (n = 37), LR-4 (n = 41), and LR-M (n = 36) on CT/MRI and LR-3 (n = 48), LR-4 (n = 36), LR-M (n = 29), and LR-TIV (n = 1) on CEUS. Of them, 43.0% (49/114) were confirmed as HCC, 37.3% (43/114) non-malignant, and 19.3% (22/114) non-hepatocellular malignancies. The highest diagnostic accuracy among the combinations of imaging features was achieved in CT/MRI LR-3 observations, where the combination of CEUS arterial phase hyper-enhancement (APHE) + CT/MRI APHE had 96.7% specificity, 75.0% positive predictive value (PPV), and 86.5% accuracy for HCC.

conclusionThe combination of LI-RADS major features on CT/MRI and CEUS showed higher specificity, PPV, and accuracy compared to individual modalities' assessments, particularly for CT/MRI LR-3 observations.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsMagnetic Resonance ImagingTomography, X-Ray ComputedAdultAgedContrast MediaFemaleHumansLiverMaleMiddle AgedMultimodal ImagingProspective StudiesReproducibility of ResultsRetrospective StudiesContrast MediaCEUSCTHCCHepatocellular carcinomaLI-RADSMRI

Identifiers

PMID39438285
PMCPMC11991985

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.