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

Table 4 Diagnostic performances of various criteria using upgraded LR-5 for the noninvasive diagnosis of hepatocellular carcinoma

Diagnostic criteria	Upgrade number	Total/final number	Sensitivity% (95%CI)	P value2	Specificity% (95%CI)	P value2
LR-5	-	105/244	60.6 (0.532-0.681)	-	93.7 (0.883-0.990)	-
LR-5-M11	51	156/244	89.1 (0.843-0.938)	0.000	88.6 (0.816-0.956)	0.263
LR-5-M2	54	159/244	87.9 (0.829-0.929)	0.000	82.3 (0.739-0.907)	0.028
LR-5-M3	16	121/244	67.9 (0.608-0.750)	0.168	88.6 (0.816-0.956)	0.263
LR-5-M41	50	155/244	88.5 (0.836-0.934)	0.000	88.6 (0.816-0.956)	0.263
LR-5-M51	53	158/244	88.5 (0.836-0.934)	0.000	84.8 (0.769-0.927)	0.072
LR-5-M6	17	122/244	68.5 (0.614-0.756)	0.135	88.6 (0.816-0.956)	0.263
LR-5-M7	11	116/244	67.3 (0.601-0.744)	0.207	93.7 (0.883-0.990)	1.000
LR-5-M81	50	155/244	89.1 (0.843-0.938)	0.000	89.9 (0.832-0.965)	0.385
LR-5-M9	70	175/244	91.5 (0.873-0.958)	0.000	69.6 (0.595-0.798)	0.000

¹By using these alternative criteria, the sensitivities were significantly increased in varying degrees, whereas specificities were not significantly different compared with the standard LR-5.

²In comparison with the standard LR-5 of LI-RADS v2018.

M: Modified; LR-5-M1: LR-4 by major features alone + TP hypointensity; LR-5-M2: LR-4 by major features alone + mild-moderate T2 hyperintensity; LR-5-M3: LR-4 by major features alone + fat in mass, more than adjacent liver; LR-5-M4: Transition phase (TP) hypointensity substitute threshold growth; LR-5-M5: Mild-moderate T2 hyperintensity substitute threshold growth; LR-5-M6: Fat in mass, more than adjacent liver substitute threshold growth; LR-5-M7: LR-3/LR-4 by major features alone + TP hypointensity + mild-moderate T2 hyperintensity + fat in mass, more than adjacent liver; LR-5-M8: LR-3/LR-4 by major features alone + any two features of TP hypointensity, mild-moderate T2 hyperintensity and fat in mass, more than adjacent liver; LR-5-M9: LR-3/LR-4 by major features alone + anyone features of TP hypointensity, mild-moderate T2 hyperintensity and fat in mass, more than adjacent liver; CI: Confidence intervals.