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논문 기본 정보

자료유형
학술저널
저자정보
Jae Seok Bae (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) 이정민 (서울대학교) Bo Yun Hur (Department of Radiology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea) 유정인 (Department of Radiology, Seoul National University Hospital, Seoul; Department of Radiology, Seoul National University College of Medicine, Seoul;) 박새진 (G&E Alphadom Medical Center, Seongnam, Korea)
저널정보
대한간암학회 Journal of Liver Cancer Journal of Liver Cancer 제24권 제2호
발행연도
2024.9
수록면
206 - 216 (11page)
DOI
10.17998/jlc.2024.05.01

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Backgrounds/Aims: The enhancing capsule (EC) in hepatocellular carcinoma (HCC) diagnosis has received varying degrees of recognition across major guidelines. This study aimed to assess the diagnostic utility of EC in HCC detection. Methods: We retrospectively analyzed patients who underwent pre-surgical computed tomography (CT) and hepatobiliary agent-enhanced magnetic resonance imaging (HBA-MRI) between January 2016 and December 2019. A single hepatic tumor was confirmed based on the pathology of each patient. Three radiologists independently reviewed the images according to the Liver Imaging Reporting and Data System (LI-RADS) v2018 criteria and reached a consensus. Interobserver agreement for EC before reaching a consensus was quantified using Fleiss κ statistics. The impact of EC on the LI-RADS classification was assessed by comparing the positive predictive values for HCC detection in the presence and absence of EC. Results: In total, 237 patients (median age, 60 years; 184 men) with 237 observations were included. The interobserver agreement for EC detection was notably low for CT (κ=0.169) and HBA-MRI (κ=0.138). The presence of EC did not significantly alter the positive predictive value for HCC detection in LI-RADS category 5 observations on CT (94.1% [80/85] vs. 94.6% [88/93], P=0.886) or HBAMRI (95.7% [88/92] vs. 90.6% [77/85], P=0.178). Conclusions: The diagnostic value of EC in HCC diagnosis remains questionable, given its poor interobserver agreement and negligible impact on positive predictive values for HCC detection. This study challenges the emphasis on EC in certain diagnostic guidelines and suggests the need to re-evaluate its role in HCC imaging.

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