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Page 8 of 10 Vezeridis et al. Hepatoma Res 2020;6:53 I http://dx.doi.org/10.20517/2394-5079.2020.36

retrospective study of 1,366 patients showed excellent specificity for HCC of 90.2% with an interreader
agreement of 0.61-0.73 for LI-RADS categories. Another retrospective study of 258 patients comparing
inexperienced and experienced radiologists showed that not only was interreader agreement high between
the two groups, but diagnostic accuracy was also excellent when using CEUS LI-RADS® (sensitivity 84.2%-
[46]
87.5%, sensitivity 90.6%-97%) . A smaller case series of 50 patients found that the interreader agreement
of CEUS LI-RADS® categories was only fair, with a kappa of 0.309, and that agreement of APHE was higher
[47]
than that of washout .
CONCLUSION
In summary, CEUS LI-RADS® is a recent addition to the constellation of LI-RADS® structured reporting
systems for HCC. Retrospective data supports a high specificity for the diagnosis of HCC by the LR-5
category, and a large multi-center prospective validation study is ongoing. Additional future areas of
expansion of CEUS LI-RADS® include treatment assessment.

DECLARATIONS
Author contributions
Conception and writing of this work: Vezeridis AM, Kono Y

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Both authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020

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