Clinical Benefit of Structured Reporting Using the Liver Imaging Reporting and Data System (LI-RADS) in MRI in Patients at Risk for Hepatocellular Carcinoma

Abstract

Purpose

The aim of this study was to evaluate the quality of structured reporting of MRI examinations in patients at risk for HCC using the Liver Imaging Reporting and Data System (LI-RADS) created during the daily clinical routine.

Materials and Methods

In this retrospective study, MRI examinations of 163 patients under HCC surveillance and HCC follow-up were analyzed. The study cohort included a group of 76 patients whose examinations were performed using free-text reporting and a group of 87 patients with structured template reporting based on the LI-RADS criteria. The diagnostic accuracy of the specified LI-RADS category was analyzed for both groups. The impact of structured reporting and the frequency of reporting of the major and ancillary LI-RADS features in free-text reports and structured reports were compared using the χ²-test.

Results

Liver lesions were classified according to LI-RADS significantly more often in the structured reports (91.4%) than in the unstructured free-text reports (82.6%) (p < 0.01). Most relevant major LI-RADS criteria were described significantly more frequently when using the structured report template compared to free text, e.g., arterial hyperenhancement 100% vs. 92.5% (p < 0.01) and washout 93.4% vs. 79.7% (p < 0.01). Only the documentation of threshold growth was not significantly improved, but absolute lesion size was reported significantly more often within the structured reports. The diagnostic accuracy of the LI-RADS category was higher for the structured reports than for the free-text reports (82.3% vs. 63.9%).

Conclusion

Structured reporting improves LI-RADS documentation in MRI reports of patients at risk for HCC and may help with multidisciplinary communication and patient management.

Key Points

• Structured reporting showed improved documentation of key features for LI-RADS classification compared to nonstructured MRI reports.

• Structured reports improve the categorization of liver lesions according to LI-RADS in patients at risk for HCC.

Citation Format

• Nelles C, Wagner A, Lennartz S et al. Clinical Benefit of Structured Reporting Using the Liver Imaging Reporting and Data System (LI-RADS) in MRI in Patients at Risk for Hepatocellular Carcinoma. Rofo 2025; DOI 10.1055/a-2553-1392

Zusammenfassung

Ziel

Ziel dieser Studie war es, die Qualität der strukturierten Befundung in der klinischen Routine von MRT-Untersuchungen bei Patienten mit Risiko für ein hepatozelluläres Karzinom (HCC) unter Verwendung des Liver Imaging Reporting and Data System (LI-RADS) zu bewerten.

Material und Methoden

In dieser retrospektiven Studie wurden MRT-Untersuchungen von 163 Patienten in der HCC-Überwachung und der HCC-Nachbeobachtung analysiert. Die Studienkohorte umfasste eine Gruppe von 76 Patienten, deren Untersuchungen mit Freitextbefunden beurteilt wurden, und eine Gruppe von 87 Patienten, deren Untersuchungen mit strukturierten Befundvorlagen auf der Grundlage der LI-RADS-Kriterien bewertet wurden. Die diagnostische Genauigkeit der angegebenen LI-RADS-Kategorie wurde für beide Gruppen berechnet. Die Auswirkungen der strukturierten Befundung und die Häufigkeit der Angabe der Haupt- und Nebenmerkmale der LI-RADS-Kriterien in Freitextbefunden und strukturierten Befunden wurden mithilfe des χ²-Tests verglichen.

Ergebnisse

Die Klassifizierung von Leberläsionen nach LI-RADS wurde in strukturierten Befunden mit 91,4% signifikant häufiger vorgenommen als in Freitextbefunden mit 82,6% (p<0,01). Die meisten relevanten LI-RADS-Hauptkriterien wurden bei Verwendung der strukturierten Befundvorlage signifikant häufiger beschrieben als in Freitextbefunden, z.B. arterielles Hyperenhancement (100% gegenüber 92,5%, p<0,01) und Wash-Out (93,4% gegenüber 79,7%, p<0,01). Lediglich die Dokumentation des Schwellenwachstums wurde nicht signifikant verbessert, jedoch wurde die absolute Größe der Läsionen signifikant häufiger in den strukturierten Befunden angegeben. Die diagnostische Genauigkeit war bei den strukturierten Befunden höher als bei den Freitextbefunden (82,3% vs. 63,9%).

Schlussfolgerung

Eine strukturierte Befundung verbessert die LI-RADS-Dokumentation in MRT-Befunden von Patienten mit Risiko für ein HCC und kann die interdisziplinäre Kommunikation und das Patientenmanagement unterstützen.

Kernaussagen

• Strukturierte Befundung zeigte eine verbesserte Dokumentation der Hauptmerkmale für die LI-RADS-Klassifizierung im Vergleich zu nicht strukturierten MRT-Freitextbefunden.

• Strukturierte Befunde verbessern die Kategorisierung von Leberläsionen gemäß LI-RADS bei Patienten mit Risiko für ein HCC.

Keywords

structured reporting - oncology - hepatocellular cancer (HCC) - Liver Imaging Reporting and Data System (LI-RADS)

Publikationsverlauf

Eingereicht: 26. Oktober 2024

Angenommen nach Revision: 28. Februar 2025

Artikel online veröffentlicht:
25. April 2025

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