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KMID : 1103720220830020331
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Journal of the Korean Society of Radiology
2022 Volume.83 No. 2 p.331 ~ p.343
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LI-RADS Treatment Response versus Modified RECIST for Diagnosing Viable Hepatocellular Carcinoma after Locoregional Therapy: A Systematic Review and Meta-Analysis of Comparative Studies
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Kim Dong-Hwan
Kim Bo-Hyun
Choi Joon-Il
Oh Soon-Nam
Rha Sung-Eun
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Abstract
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Purpose: To systematically compare the performance of liver imaging reporting and data system treatment response (LR-TR) with the modified Response Evaluation Criteria in Solid Tumors (mRECIST) for diagnosing viable hepatocellular carcinoma (HCC) treated with locoregional therapy (LRT).
Materials and Methods: Original studies of intra-individual comparisons between the diagnostic performance of LR-TR and mRECIST using dynamic contrast-enhanced CT or MRI were searched in MEDLINE and EMBASE, up to August 25, 2021. The reference standard for tumor viability was surgical pathology. The meta-analytic pooled sensitivity and specificity of the viable category using each criterion were calculated using a bivariate random-effects model and compared using bivariate meta-regression.
Results: For five eligible studies (430 patients with 631 treated observations), the pooled per-lesion sensitivities and specificities were 58% (95% confidence interval [CI], 45%?70%) and 93% (95% CI, 88%?96%) for the LR-TR viable category and 56% (95% CI, 42%?69%) and 86% (95% CI, 72%?94%) for the mRECIST viable category, respectively. The LR-TR viable category provided significantly higher pooled specificity (p < 0.01) than the mRECIST but comparable pooled sensitivity (p = 0.53).
Conclusion: The LR-TR algorithm demonstrated better specificity than mRECIST, without a significant difference in sensitivity for the diagnosis of pathologically viable HCC after LRT.
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KEYWORD
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Hepatocellular Carcinoma, Treatment Outcome, Systematic Review, Meta-Analysis, Response Evaluation Criteria in Solid Tumors
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