Modified LR-5 criteria based on gadoxetic acid can improve the sensitivity in the diagnosis of hepatocellular carcinoma

doi:10.4329/wjr.v17.i3.103822

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Mar 28, 2025 (publication date) through Apr 28, 2025

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World Journal of Radiology

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World J Radiol. Mar 28, 2025; 17(3): 103822
Published online Mar 28, 2025. doi: 10.4329/wjr.v17.i3.103822

Table 3 Diagnostic performance and logistic regression analyses of major features and ancillary features favoring malignancy in Liver Imaging Reporting and Data System version 2018 for diagnosing hepatocellular carcinoma

Features	Diagnostic performance (%)		Univariable analysis		Multivariable analysis
Features	Sensitivity	Specificity	OR (95%CI)	P value	OR (95%CI)	P value
Major features
Size of lesions (≤ 20 mm; > 20 mm)	73.3 (121/165)	40.5 (32/79)	1.872(1.063-3.299)	0.029^a	0.969 (0.281-3.339)	0.960
Nonrim APHE	88.5 (146/165)	49.4 (39/79)	7.492(3.910-14.357)	0.000^a	18.913 (5.437-65.788)	0.000^b
Nonperipheral “washout”	58.8 (97/165)	88.6 (70/79)	11.095 (5.188-23.727)	0.000^a	3.443 (0.920-12.887)	0.006^b
Threshold growth	1.2 (2/165)	96.2 (76/79)	0.311(0.051-1.899)	0.395	-	-
Enhancing “capsule”	49.7 (82/165)	94.9 (75/79)	18.524 (6.475-52.991)	0.000^a	7.126 (1.209-42.004)	0.030^b
Malignant ancillary features favoring HCC
Mosaic architecture	51.5 (85/165)	74.7 (59/79)	3.134 (1.734-5.665)	0.000^a	0.687 (0.188-2.516)	0.571
Nonenhancing “capsule”	4.2 (7/165)	96.2 (76/79)	1.122 (0.282-4.461)	1.000	-	-
Blood products in mass	38.2 (63/165)	91.1 (73/79)	6.353 (2.751-14.673)	0.000^a	1.833 (0.385-8.730)	0.446
Fat in mass, more than adjacent liver	30.3 (50/165)	89.9 (71/79)	3.859 (1.729-8.612)	0.000^a	9.846 (2.042-47.467)	0.004^b
Nodule-in-nodule	30.3 (50/165)	93.7 (74/79)	6.435 (2.453-16.883)	0.000^a	0.995 (0.200-4.949)	0.995
Favoring malignancy in general
Corona enhancement	15.2 (25/165)	84.8 (67/79)	0.997 (0.472-2.105)	0.994	-	-
Restricted diffusion	86.7 (143/165)	57.0 (45/79)	8.603 (4.571-16.190)	0.000^a	0.697 (0.142-3.432)	0.658
Mild-moderate T2 hyperintensity	95.2 (157/165)	86.3 (50/79)	33.836 (14.535-78.766)	0.000^a	13.516 (2.568-71.131)	0.002^b
Fat sparing in solid mass	4.8 (8/165)	98.7 (78/79)	3.975 (0.488-32.344)	0.305	-	-
Iron sparing in solid mass	6.1 (10/165)	96.2 (76/79)	1.634 (0.437-6.113)	0.666	-
Transitional phase hypointensity	93.9 (155/165)	68.4 (54/79)	33.480 (15.103-74.219)	0.000^a	43.403 (10.479-179.770)	0.000^b
Hepatobiliary phase hypointensity	93.3 (154/165)	32.9 (26/79)	6.868 (3.177-14.848)	0.000^a	0.999 (0.230-4.344)	0.999
Subthreshold growth	5.5 (9/165)	94.9 (75/79)	1.082 (0.323-3.626)	1.000	-	-

^aP < 0.2 in univariable analysis.

^bP < 0.05 in multivariable analysis.

OR: Odds ratio; CI: Confidence intervals; APHE: Arterial phase hyperenhancement; HCC: Hepatocellular carcinoma.

Citation: Song Y, Zhang YY, Yu Q, Ma R, Xiao Y, Shen JK, Wei CG. Modified LR-5 criteria based on gadoxetic acid can improve the sensitivity in the diagnosis of hepatocellular carcinoma. World J Radiol 2025; 17(3): 103822
URL: https://www.wjgnet.com/1949-8470/full/v17/i3/103822.htm
DOI: https://dx.doi.org/10.4329/wjr.v17.i3.103822