Evidence map›Paper›PMID 40015564›Full record

ArticleKorean journal of radiology2025

Combination of CT/MRI LI-RADS With Second-Line Contrast-Enhanced Ultrasound Using Sulfur Hexafluoride or Perfluorobutane for Diagnosing Hepatocellular Carcinoma in High-Risk Patients.

Yu Li, Sheng Li, Qing Li, Kai Li, Jing Han, Siyue Mao, Xiaohong Xu, Zhongzhen Su, Yanling Zuo, Shousong Xie and 5 more

Abstract readMulticenter Study
In one paragraph

Article in Korean journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

15 authors.

Yu Li *Department of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.ORCID 0000-0001-6935-6353
Sheng Li *Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.ORCID 0000-0003-1419-3475
Qing LiDepartment of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.ORCID 0000-0002-8632-9637
Kai LiDepartment of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.ORCID 0000-0003-3982-494X
Jing HanDepartment of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.ORCID 0000-0003-3187-1397
Siyue MaoDepartment of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.ORCID 0000-0003-0337-3673
Xiaohong XuDepartment of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.ORCID 0000-0002-3860-9845
Zhongzhen SuDepartment of Ultrasound, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.ORCID 0000-0002-7281-7357
Yanling ZuoDepartment of Ultrasound Imaging, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China.ORCID 0009-0000-7457-104X
Shousong XieDepartment of Ultrasound, The First People's Hospital of Foshan, Foshan, China.ORCID 0009-0003-6619-8363
Hong WenDepartment of Ultrasound, Huizhou Central People's Hospital, Huizhou, China.ORCID 0009-0007-5638-9923
Xuebin ZouDepartment of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.ORCID 0000-0002-3484-9673
Jingxian ShenDepartment of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.ORCID 0000-0002-9233-2576
Lingling LiDepartment of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China. lill@sysucc.org.cn.ORCID 0000-0003-4596-8712
Jianhua ZhouDepartment of Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China. zhoujh@sysucc.org.cn.ORCID 0000-0003-2096-8126

Funding

NNSFC 82320108011
6 · The paper itself

Abstract

objectiveThe CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). MATERIALS AND

methodsThis retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB.

resultsIn total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%-79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%-87%], 84% [95% CI: 79%-89%], 88% [95% CI: 83%-92%], respectively; all

conclusionThe combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Indexed as

Carcinoma, HepatocellularContrast MediaLiver NeoplasmsMagnetic Resonance ImagingSulfur HexafluorideTomography, X-Ray ComputedAdultAgedFemaleFluorocarbonsHumansMaleMiddle AgedMultimodal ImagingRetrospective StudiesSensitivity and SpecificityContrast MediaFluorocarbonsperfluorobutaneSulfur HexafluorideComputed tomographyContrast-enhanced ultrasoundHepatocellular carcinomaJoint diagnosisLiver imaging reporting and data systemMagnet resonance imaging

Identifiers

PMID40015564
PMCPMC11955382

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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.