LI-RADS和EASL诊断标准仅适用于高肝癌风险患者。本系统性综述评估了已发表文献中对LI-RADS和EASL高风险人群标准的遵循程度。在PubMed上搜索了2012年1月至2021年12月发表的有关CEUS、CT或MRI LI-RADS和EASL诊断标准的原始研究。针对每个研究记录算法版本、发表年份、风险状态和慢性肝病的病因。将高风险人群标准的遵循程度评为优良(明确遵循)、亚优良(暧昧)或不良(明显违反)。共纳入219个原始研究，其中215个使用LI-RADS标准、4个仅使用EASL标准，15个同时评估LI-RADS和EASL标准。无论使用的图像模态是什么，高风险人群标准的优良、亚优良或不良遵循程度分别在111/215 (51.6%)、86/215 (40.0%)、18/215 (8.4%) LI-RADS研究和6/19 (31.6%)、5/19 (26.3%)、8/19 (42.1%) EASL研究中观察到(P<0.001)。按LI-RADS CT/MRI版本(2018版64.5%的研究、2017版45.8%、2014版24.4%、2013.1版33.3%；P<0.001)和发表年份(2020-2021年62.5%、2018-2019年33.9%、2014-2017年39.3%的所有LI-RADS研究；P=0.002)显著改善了高风险人群标准的遵循程度。检测到CEUS LI-RADS (P=0.388)或EASL (P=0.293)版本对高风险人群标准的遵循程度没有显著差异。LI-RADS和EASL研究中约90%和60%的高风险人群标准的遵循程度为优良或亚优良。版权所有©2023年美国肝脏疾病研究协会。

LI-RADS and EASL diagnostic criteria for the noninvasive diagnosis hepatocellular carcinoma (HCC) can only be applied to patients at high risk of HCC. This systematic review assesses adherence to the LI-RADS and EASL high-risk population criteria in published studies.PubMed was searched for original research, published between January 2012 and December 2021, reporting LI-RADS and EASL diagnostic criteria on CEUS, CT, or MRI. The algorithm version, publication year, risk status, and etiologies of chronic liver disease were recorded for each study. Adherence to high-risk population criteria was evaluated as optimal (unequivocal adherence), suboptimal (equivocal), or inadequate (clear violation). A total of 219 original studies were included with 215 that used the LI-RADS criteria, four EASL only, and 15 that evaluated both LI-RADS and EASL criteria. Optimal, suboptimal, or inadequate adherence to high-risk population criteria was observed in 111/215 (51.6%), 86/215 (40.0%), 18/215 (8.4%) LI-RADS and 6/19 (31.6%), 5/19 (26.3%), 8/19 (42.1%) EASL studies (P<0.001) regardless of the imaging modality, respectively. Adherence to high-risk population criteria significantly improved according to the CT/MRI LI-RADS versions (optimal in v2018 in 64.5% studies; v2017, 45.8%; v2014, 24.4%; v2013.1, 33.3%; P<0.001) and publication year (2020-2021, 62.5%; 2018-2019, 33.9%; 2014-2017, 39.3% of all LI-RADS studies; P=0.002). No significant differences in adherence to high-risk population criteria were observed in the versions of CEUS LI-RADS (P=0.388) or EASL (P=0.293).Adherence to high-risk population criteria was optimal or suboptimal in about 90% and to 60% of LI-RADS and EASL studies, respectively.Copyright © 2023 American Association for the Study of Liver Diseases.