Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes · 2024
Do Risk Factors for HCC Impact the Association of CT/MRI LIRADS Major Features With HCC? An Individual Participant Data Meta-Analysis.
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Adamo Robert G, Lam Eric, Salameh Jean-Paul, van der Pol Christian B, Goins Stacy M, Dawit Haben, Costa Andreu F, Levis Brooke, Singal Amit G, Chernyak Victoria, Sirlin Claude B, Bashir Mustafa R, Tang An, Alhasan Ayman, Allen Brian C, Reiner Caecilia S, Clarke Christopher, Ludwig Daniel R, Cerny Milena, Wang Jin, Hyun Choi Sang, Fraum Tyler J, Song Bin, Joo Ijin, Yeon Kim So, Kwon Heejin, Jiang Hanyu, Kang Hyo-Jin, Kierans Andrea S, Kim Yeun-Yoon, Ronot Maxime, Podgórska Joanna, Rosiak Grzegorz, Soo Song Ji, McInnes Matthew D F
Аннотация
Background: Guidelines suggest the Liver Imaging Reporting and Data System (LI-RADS) may not be applicable for some populations at risk for hepatocellular carcinoma (HCC). However, data assessing the association of HCC risk factors with LI-RADS major features are lacking. Purpose: To evaluate whether the association between HCC risk factors and each CT/MRI LI-RADS major feature differs among individuals at-risk for HCC. Methods: Databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus) were searched from 2014 to 2022. Individual participant data (IPD) were extracted from studies evaluating HCC diagnosis using CT/MRI LI-RADS and reporting HCC risk factors. IPD from studies were pooled and modelled with one-stage meta-regressions. Interactions were assessed between major features and HCC risk factors, including age, sex, cirrhosis, chronic hepatitis B virus (HBV), and study location. A mixed effects model that included the major features, as well as separate models that included interactions between each risk factor and each major feature, were fit. Differences in interactions across levels of each risk factor were calculated using adjusted odds-ratios (ORs), 95% confidence-intervals (CI), and z-tests. Risk of bias was assessed using QUADAS-2. (Protocol: https://osf.io/tdv7j/). Results: Across 23 studies (2958 patients and 3553 observations), the associations between LI-RADS major features and HCC were consistent across several HCC risk factors (P-value range: .09-.99). A sensitivity analysis among the 4 studies with a low risk of bias did not differ from the primary analysis. Conclusion: The association between CT/MRI LI-RADS major features and HCC risk factors do not significantly differ in individuals at-risk for HCC. These findings suggest that CT/MR LI-RADS should be applied to all patients considered at risk by LI-RADS without modification or exclusions, regardless of the presence or absence of the risk factors evaluated in this study.