Diagnostic value of ACR CEUS LI-RADS for hepatocellular carcinoma in high-risk and non-high-risk populations

Corresponding author: Xu Chen, ccdyx77@163.com

DOI: 10.12201/bmr.202601.00041

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  Abstract: Objective To evaluate the diagnostic value of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) for hepatocellular carcinoma (HCC) in high-risk and non-high-risk populations. Methods Retrospectively analyzed the ultrasound contrast imaging results of 538 patients with intrahepatic focal lesions, referring to the ACR CEUS LI-RADS criteria, grouping into high-risk and non-high-risk categories based on HCC risk factors (cirrhosis, chronic HBV hepatitis, HCC history, etc.), and grading the lesions. Then assessing the diagnostic value of ACR CEUS LI – RADS in high-risk and non-high-risk populations by comparing with final surgical or biopsy pathology outcomes. Results The high-risk group comprised 309 cases, and the non-high-risk group 229. Using the LR-5/M categories for diagnosing malignant tumors, the sensitivities in diagnosing malignant tumors with LR-5/M classification were 90.2% and 94.7%, with AUC values 0.783(95%CI：0.729~0.836) and 0.807(95%CI：0.739~0.875)respectively. For LR-5 HCC diagnosis, sensitivity was 60.4% in the high-risk group and 64.7% in the non-high-risk group, specificity was 96.1% and 98.6%, positive predictive value was 93.9% and 78.6%, with AUC values 0.783 (95% CI: 0.729~0.836) and 0.816 (95%CI:0.676~0.957) respectively. For LR-M classification in diagnosing other hepatic malignancies (OM), the sensitivity was 94.0% and 93.2%, with AUC values 0.850 (95%CI:0.806~0.895) and 0.809 (95%CI:0.746~0.871) respectively. Conclusion The application of the LR-5/M categories in both high-risk and non-high-risk groups can provide an initial assessment of whether a lesion is benign or malignant. LR-5 is highly valuable for HCC diagnosis in high-risk patients. while LR-M shows high sensitivity in differentiating HCC from other malignancies across both groups.

  Key words: Contrast-enhanced ultrasound，Liver image report and data management system ，Malignant ，Hepatocellular carcinoma; ; ; 

  Submit time: 14 January 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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