Diagnostic Performance and Clinical Implications of the "Probable Hepatocellular Carcinoma" Category in the Korean Liver Cancer Association-National Cancer Center Korea Guidelines v2022.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 3/4)
유사 논문P · Population 대상 환자/모집단
237 patients (1,666 men; mean age, 59 ± 11 years) with 2,445 lesions were included.
I · Intervention 중재 / 시술
gadoxetic acid-enhanced MRI between January 2015 and June 2018; a subgroup of these patients also underwent liver CT
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSION] The revised "probable HCC" category in the KLCA-NCC v2022 aligns with updates in the diagnostic flow, demonstrating acceptable performance on MRI and CT. Notably, FNH or FNH-like nodules can be misclassified as "probable HCC" when MRI is used.
[OBJECTIVE] To evaluate the diagnostic performance of the "probable hepatocellular carcinoma (HCC)" category in the Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) v2022 guidelines.
- 표본수 (n) 1,590
- Sensitivity 83.7%
- Specificity 77.1%
APA
Yoon JH, Choi JY, et al. (2026). Diagnostic Performance and Clinical Implications of the "Probable Hepatocellular Carcinoma" Category in the Korean Liver Cancer Association-National Cancer Center Korea Guidelines v2022.. Korean journal of radiology, 27(4), 318-331. https://doi.org/10.3348/kjr.2025.1178
MLA
Yoon JH, et al.. "Diagnostic Performance and Clinical Implications of the "Probable Hepatocellular Carcinoma" Category in the Korean Liver Cancer Association-National Cancer Center Korea Guidelines v2022.." Korean journal of radiology, vol. 27, no. 4, 2026, pp. 318-331.
PMID
41776851 ↗
Abstract 한글 요약
[OBJECTIVE] To evaluate the diagnostic performance of the "probable hepatocellular carcinoma (HCC)" category in the Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) v2022 guidelines.
[MATERIALS AND METHODS] This multicenter retrospective study included patients at risk of HCC who underwent gadoxetic acid-enhanced MRI between January 2015 and June 2018; a subgroup of these patients also underwent liver CT. Eligible patients had at least one non-cystic lesion (≥10 mm) with a reference standard. Four radiologists interpreted the images independently and the results were pooled. The performance of "definite HCC" and "probable HCC" together and "probable HCC" alone were compared between v2018 and v2022.
[RESULTS] A total of 2,237 patients (1,666 men; mean age, 59 ± 11 years) with 2,445 lesions were included. In v2022, 1.5% (143/9,780) of the lesions were additionally categorized as "probable HCC" by four reviewers on MRI; among these, 104 lesions were not HCCs. Focal nodular hyperplasia (FNH) or FNH-like nodules constituted 90.4% (94/104) of the false positives. When "definite HCC" and "probable HCC" were combined, v2022 showed higher sensitivity (83.7% [5,670/6,776] vs. 83.1% [5,631/6,776]) but lower specificity (77.1% [2,316/3,004] vs. 80.6% [2,420/3,004]) than v2018 ( < 0.001). For "probable HCC" alone, v2022 showed a lower positive predictive value (PPV) than v2018 (64.1% [373/582] vs. 76.1% [334/439], < 0.001). In v2022, lesions with non-rim arterial-phase hyperenhancement (APHE) showed a lower PPV than those without APHE (42.3% [91/215] vs. 76.8% [282/367], < 0.001). In the CT subgroup (n = 1,590), 1.6% (99/6,360) of the lesions were reassessed as "probable HCC," and its PPV was 83.8% (83/99) in v2022 whereas no lesions were classified as "probable HCC" under v2018.
[CONCLUSION] The revised "probable HCC" category in the KLCA-NCC v2022 aligns with updates in the diagnostic flow, demonstrating acceptable performance on MRI and CT. Notably, FNH or FNH-like nodules can be misclassified as "probable HCC" when MRI is used.
[MATERIALS AND METHODS] This multicenter retrospective study included patients at risk of HCC who underwent gadoxetic acid-enhanced MRI between January 2015 and June 2018; a subgroup of these patients also underwent liver CT. Eligible patients had at least one non-cystic lesion (≥10 mm) with a reference standard. Four radiologists interpreted the images independently and the results were pooled. The performance of "definite HCC" and "probable HCC" together and "probable HCC" alone were compared between v2018 and v2022.
[RESULTS] A total of 2,237 patients (1,666 men; mean age, 59 ± 11 years) with 2,445 lesions were included. In v2022, 1.5% (143/9,780) of the lesions were additionally categorized as "probable HCC" by four reviewers on MRI; among these, 104 lesions were not HCCs. Focal nodular hyperplasia (FNH) or FNH-like nodules constituted 90.4% (94/104) of the false positives. When "definite HCC" and "probable HCC" were combined, v2022 showed higher sensitivity (83.7% [5,670/6,776] vs. 83.1% [5,631/6,776]) but lower specificity (77.1% [2,316/3,004] vs. 80.6% [2,420/3,004]) than v2018 ( < 0.001). For "probable HCC" alone, v2022 showed a lower positive predictive value (PPV) than v2018 (64.1% [373/582] vs. 76.1% [334/439], < 0.001). In v2022, lesions with non-rim arterial-phase hyperenhancement (APHE) showed a lower PPV than those without APHE (42.3% [91/215] vs. 76.8% [282/367], < 0.001). In the CT subgroup (n = 1,590), 1.6% (99/6,360) of the lesions were reassessed as "probable HCC," and its PPV was 83.8% (83/99) in v2022 whereas no lesions were classified as "probable HCC" under v2018.
[CONCLUSION] The revised "probable HCC" category in the KLCA-NCC v2022 aligns with updates in the diagnostic flow, demonstrating acceptable performance on MRI and CT. Notably, FNH or FNH-like nodules can be misclassified as "probable HCC" when MRI is used.
🏷️ 키워드 / MeSH 📖 같은 키워드 OA만
- Humans
- Liver Neoplasms
- Carcinoma
- Hepatocellular
- Male
- Middle Aged
- Retrospective Studies
- Female
- Republic of Korea
- Magnetic Resonance Imaging
- Contrast Media
- Practice Guidelines as Topic
- Gadolinium DTPA
- Tomography
- X-Ray Computed
- Aged
- Sensitivity and Specificity
- Liver
- Diagnosis
- Gadoxetic acid
- Guidelines
- Hepatocellular carcinoma
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