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| 1 | Contrast-enhanced ultrasound Liver Imaging Reporting and Data System:Lights and shadows in hepatocellular carcinoma and cholangiocellular carcinoma diagnosis显示文摘BACKGROUND Contrast-enhanced ultrasound(CEUS)is considered a secondary examination compared to computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of hepatocellular carcinoma(HCC),due to the risk of misdiagnosing intrahepatic cholangiocarcinoma(ICC).The introduction of CEUS Liver Imaging Reporting and Data System(CEUS LI-RADS)might overcome this limitation.Even though data from the literature seems promising,its reliability in real-life context has not been well-established yet.AIM To test the accuracy of CEUS LI-RADS for correctly diagnosing HCC and ICC in cirrhosis.METHODS CEUS LI-RADS class was retrospectively assigned to 511 nodules identified in 269 patients suffering from liver cirrhosis.The diagnostic standard for all nodules was either biopsy(102 nodules)or CT/MRI(409 nodules).Common diagnostic accuracy indexes such as sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were assessed for the following associations:CEUS LR-5 and HCC;CEUS LR-4 and 5 merged class and HCC;CEUS LR-M and ICC;and CEUS LR-3 and malignancy.The frequency of malignant lesions in CEUS LR-3 subgroups with different CEUS patterns was also determined.Inter-rater agreement for CEUS LI-RADS class assignment and for major CEUS pattern identification was evaluated.RESULTS CEUS LR-5 predicted HCC with a 67.6%sensitivity,97.7%specificity,and 99.3%PPV(P<0.001).The merging of LR-4 and 5 offered an improved 93.9%sensitivity in HCC diagnosis with a 94.3%specificity and 98.8%PPV(P<0.001).CEUS LR-M predicted ICC with a 91.3%sensitivity,96.7%specificity,and 99.6%NPV(P<0.001).CEUS LR-3 predominantly included benign lesions(only 28.8%of malignancies).In this class,the hypo-hypo pattern showed a much higher rate of malignant lesions(73.3%)than the iso-iso pattern(2.6%).Inter-rater agreement between internal raters for CEUS-LR class assignment was almost perfect(n=511,k=0.94,P<0.001),while the agreement among raters from separate centres was substantial(n=50,k=0.67,P<0.001).Agreement was stronger for arterial phase hyperenhancement(internal k=0.86,P<2.7×10-214;external k=0.8,P<0.001)than washout(internal k=0.79,P<1.6×10-202;external k=0.71,P<0.001).CONCLUSION CEUS LI-RADS is effective but can be improved by merging LR-4 and 5 to diagnose HCC and by splitting LR-3 into two subgroups to differentiate iso-iso nodules from other patterns. | Gianpaolo Vidili Marco Arru Giuliana Solinas Diego Francesco Calvisi Pierluigi Meloni Assunta Sauchella Davide Turilli Claudio Fabio Antonio Cossu Giordano Madeddu Sergio Babudieri Maria Assunta Zocco Giovanni Iannetti Enza Di Lembo Alessandro Palmerio Delitala Roberto Manetti | 2022 | World Journal of Gastroenterology2022，28，27： | 3 |
| 2 | Microsurgery posterior fossa exploration for trigeminal neuralgia:a study on 48 cases显示文摘 | Delitala A Brunori A | 2001 | Minim Invasve Neurosurgery2001，44，3： | 1 |
| 3 | Prevalence of silent celiac disease in patients with autoimmune thyroiditis from Northern Sardinia显示文摘 | G. F. Meloni P. A. Tomasi A. Bertoncelli G. Fanciulli G. Delitala T. Meloni | 2001 | Journal of Endocrinological Investigation2001，，5： | 1 |
| 4 | Number of autoantibodies and HLA genotype, more than high titers of glutamic acid decarboxylase autoantibodies, predict insulin dependence in latent autoimmune diabetes of adults显示文摘 | Maioli M Pes GM Delitala G | 2010 | EurJ Endocrinol2010，163，4： | 1 |
| 5 | Revisional Surgery After Sleeve Gastrectomy显示文摘 | Antonio Lacy Ainitze Obarzabal Elizabeth Pando Cedric Adelsdorfer Alberto Delitala Ricard Corcelles Salvadora Delgado Josep Vidal | 2010 | Surgical Laparoscopy Endoscopy & Percutaneous Techniques2010，，5： | 1 |
| 6 | Prevalence of unknown thyroid disorders in a Sardinian cohort 显示文摘 | Delitala AP Pilia MG Ferreli L | 2014 | Eur J Endocrinol2014，171，1： | 1 |
| 7 | Altered morning and nighttime pulsatile corticotropin andcortisol release in polycystic ovary syndrome显示文摘 | Invitti C De Martin M Delitala G | 1998 | Metabolism1998，47，2： | 1 |
| 8 | Revisional Surgery After Sleeve Gastrectomy显示文摘 | Antonio Lacy Ainitze Obarzabal Elizabeth Pando Cedric Adelsdorfer Alberto Delitala Ricard Corcelles Salvadora Delgado Josep Vidal | 2010 | Surgical Laparoscopy, Endoscopy & Percutaneous Techniques2010，，5： | 1 |
| 9 | Infectious diseases and autoimmunity显示文摘 | Delogu L G Deidda S Delitala G | 2011 | J Infect Dev Ctries2011，5，10： | 1 |
| 10 | Mathematical topics on the modelling complex muhieeUular systems and tumor immune cells competion显示文摘 | BELLOMO N BELLOUQUID A DELITALA M | 2004 | Math Mod Meth Appl Sci2004，14，： | 1 |
| 11 | Altered morning and nighttime pulsatile corticotmpin and cortisol release in polycystic ovary syndrome显示文摘 | Invitti C Delitala G Veldhuis JD | 1998 | Metabolism1998，47，2： | 1 |
| 12 | Altered morning and nighttime pulsatile corticotropin and cortisol release in polycystic ovary syndrome显示文摘 | Invitti C De Martin M Delitala G | 1998 | Metabolism1998，47，2： | 1 |
| 13 | Primary symptomaticadrenal insufficiency induced by megestrol acetate显示文摘 | Delitala AP Fanciullu G Maioli M | 2013 | Neth JMed2013，71，： | 1 |
| 14 | Number of autoanti- bodies and HLA genotype, more than high titers of glutamic acid decarboxylase autoantibodies, predict insulin depen- dence in latent autoimmune diabetes of adults 显示文摘 | Maioli M Pes GM Delitala G | 2010 | European journal of endocrinology2010，163，4： | 1 |
| 15 | Mathematical Modeling of Vehicular Traffic:A Discrete Kinetic Theory Approach显示文摘 | DELITALA M TOSIN A | 2007 | Mathematical Models and Methods in Applied Sciences2007，17，6： | 1 |
| 16 | No evidence of association between subclinical thyroid disorders and common carotid intima medial thickness or atherosclerotic plaque显示文摘 | DELITALA AP FILIGHEDDU F ORR M | 2015 | Nutr metab cardiovasc dis2015，25，12： | 1 |
| 17 | Mathematical topics on the modelling complex multicellular systems and tumor immune cells competition显示文摘 | Bellomo N Bellouquid A Delitala M | 2004 | Math Models Methods Appl Sci2004，14，： | 1 |
| 18 | Allelic variant in CTLA4 is associated with thyroid failure and faster 显示文摘 | Delitala AP FanciuUi G Zoledziewska M et at | 2015 | J Diabetes2015，7，1： | 1 |
| 19 | Altered morningand nighttime pulsatile corticotropin andcortisol release in polycystic ovary syndrome显示文摘 | Invitti Ce Martin MD Delitala G | 1998 | Metabolism1998，47，2： | 1 |
| 20 | Infectious diseases and autoimmunity显示文摘 | Delogu LG Deidda S Delitala G | 2011 | J Infect Dev Ctries2011，5，10： | 1 |
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