Combination of CT/MRI LI-RADS with CEUS can improve the diagnostic performance for HCCs.BACKGROUND & AIMS
 To compare the classifications for focal liver lesions smaller than 3 cm by the CEUS and CT/MRI LI-RADS and explore the discrepancy between the two classifications strategies.


 Focal liver lesions with a size smaller than 3 cm undergoing CEUS and CT/MRI (MR required on a 3.0 T magnet) within 1 month were enrolled.  Each nodule was categorized according to the CEUS LI-RADS v2017 (usLI-RADS) and CT/MRI LI-RADS v2018.  The reasons for inconsistent classifications by the CEUS and CT/MRI LI-RADS were clarified.


 The positive predictive value (PPV) for HCCs of LR-3, 4 and 5 were 57.1% (95% CI: 32.6-78.6), 75.0% (95% CI: 62.3-84.5) and 94.2% (95% CI: 88.9-97.0) for CT/MRI and 37.5% (95% CI: 18.5-61.4), 56.0% (95% CI: 37.1-73.3) and 97.9% (95% CI: 94.1-99.3) for CEUS, respectively.  CECT/MRI and CEUS LI-RADS had a poor agreement in classification with a kappa value of 0.254 (P < 0.001).  84 lesions (39.4%) were classified inconsistently in CT/MRI and CEUS LI-RADS.  40 lesions classified as LR-3 or LR-4 by CT/MRI were upgraded by CEUS.  21 lesions classified as LR-4 or LR-5 by CT/MRI were downgraded by CEUS.  We reclassified the lesion in CT/MRI LR-3 and LR-4 by CEUS.  Reclassification of lesions in CT/MRI LR-3 and 4 using CEUS can help the corresponding HCCs get a definite diagnosis.
CEUS
Combination of CT/MRI LI-RADS with CEUS can improve the diagnostic performance for HCCs.BACKGROUND & AIMS
 To compare the classifications for focal liver lesions smaller than 3 cm by the CEUS and CT/MRI LI-RADS and explore the discrepancy between the two classifications strategies.


 Each nodule was categorized according to the CEUS LI-RADS v2017 (usLI-RADS) and CT/MRI LI-RADS v2018.  The reasons for inconsistent classifications by the CEUS and CT/MRI LI-RADS were clarified.



CT/MRI LI-RADS