The Liver Imaging Reporting and Data System tumor-in-vein category: a systematic review and meta-analysis
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HEPATOBILIARY-PANCREAS
The Liver Imaging Reporting and Data System tumor-in-vein category: a systematic review and meta-analysis Dong Hwan Kim 1,2 & Sang Hyun Choi 1 Seung Soo Lee 1 & Joon-Il Choi 2
&
Seong Ho Park 1 & Kyung Won Kim 1 & Jae Ho Byun 1 & So Yeon Kim 1 &
Received: 7 May 2020 / Revised: 7 July 2020 / Accepted: 10 September 2020 # European Society of Radiology 2020
Abstract Objectives We aimed to systematically determine the etiology of the Liver Imaging Reporting and Data System (LI-RADS) tumorin-vein category (LR-TIV) on contrast-enhanced CT or MRI and to determine the sources of heterogeneity between reported results. Methods Original studies reporting the etiology of LR-TIV were identified in MEDLINE and EMBASE up until July 7, 2020. The meta-analytic pooled percentages of HCC and non-HCC in LR-TIV were calculated. Subgroup analyses were performed according to the type of reference standard and the most common underlying liver disease. Meta-regression analysis was performed to explore study heterogeneity. Results Sixteen studies reported the etiology of a total of 150 LR-TIV, of which 98 (65%) were HCC and 52 (35%) were nonHCC. The meta-analytic pooled percentages of HCC and non-HCC in LR-TIV were 70.9% (95% confidence interval [CI], 55.7– 82.5%; I2 = 59%) and 29.2% (95% CI, 17.5–44.4%; I2 = 59%), respectively. The meta-analytic pooled percentage of HCC was lower in studies using only pathology as a reference standard (67.1%; 95% CI, 49.3–81.1%), but higher in studies in which hepatitis C was the most common underlying liver disease (81.9%; 95% CI, 11.3–99.4%) than that in the total 16 studies. Study type (cohort study versus case-control study) was significantly associated with study heterogeneity (p = 0.04). Conclusion The most common etiology of LR-TIV was HCC. It might be important to understand the percentage of HCC and non-HCC in LR-TIV in consideration of the type of reference standard, geographic differences, and study design. Key Points • The most common etiology of Liver Imaging Reporting and Data System (LI-RADS) tumor-in-vein category (LR-TIV) was hepatocellular carcinoma (HCC). • The percentage of HCC in LR-TIV was relatively low in studies using only pathology as a reference standard, but high in studies in which hepatitis C was the most common underlying liver disease. • Study type was a factor significantly influencing study heterogeneity. Keywords Liver . Hepatocellular carcinoma . Diagnosis . Systematic review . Meta-analysis Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-07282-x) contains supplementary material, which is available to authorized users. * Sang Hyun Choi [email protected] 1
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 05505, Republic of Korea
2
Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul
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