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Meta-analysis of the accuracy of Liver Imaging Reporting and Data System category 4 or 5 for diagnosing hepatocellular carcinoma
  1. Dong Hwan Kim1,2,
  2. Sang Hyun Choi1,
  3. Seong Ho Park1,
  4. Kyung Won Kim1,
  5. Jae Ho Byun1,
  6. So Yeon Kim1,
  7. Seung Soo Lee1,
  8. Yong Moon Shin1,
  9. Hyung Jin Won1,
  10. Pyo-Nyun Kim1
  1. 1 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
  2. 2 Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  1. Correspondence to Prof Sang Hyun Choi, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 05505, Republic of Korea; edwardchoi83{at}gmail.com

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We read with great interest the paper by Gerbes et al 1 summarising recent advances in the treatment of hepatocellular carcinoma (HCC), and that by De Toni et al 2 reporting the importance of early diagnosis for survival of HCC. As these papers suggest, early HCC diagnosis needs to be improved, and the use of MRI for diagnosing HCC is increasing.

Contrary to most other cancers, a non-invasive diagnosis based on imaging characteristics without mandatory pathological confirmation is acceptable for HCC.3–5 However, previous major guidelines have lacked exact definitions of the imaging diagnostic criteria for HCC.6 This could be more problematic for MRI, which provides multiparametric information from complex MRI sequences. To standardise the imaging interpretation of lesions in patients at risk of HCC, the Liver Imaging Reporting and Data System (LI-RADS) was introduced in 2011,6 updated in 2018,7 and fully integrated into the American …

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