Evidence-based radiologist-supervised automated Liver Imaging Reporting and Data System categorization for the diagnosis of hepatocellular carcinoma

Table 1 Baseline characteristics of patients in the internal and external datasets, mean ± SD/n (%)

Characteristics	Datasets from center 1 (n = 337)	Training and validation set from center 1 (n = 275)	Internal testing set from center 1 (n = 62)	External testing set 1 from center 2 (n = 76)	External testing set 2 from center 3 (n = 97)
Age (years)	53.9 ± 11.3 (24-81)	53.7 ± 11.1 (26-81)	54.7 ± 12.2 (24-81)	59.5 ± 12.1 (30-83)	55.6 ± 11.5 (28-81)
Sex
Male	286 (84.9)	229 (83.3)	57 (91.9)	59 (77.6)	84 (86.6)
Female	51 (15.1)	46 (16.7)	5 (8.1)	17 (22.4)	13 (13.4)
Etiology
Hepatitis B	265 (78.6)	218 (79.3)	47 (75.8)	56 (73.7)	86 (88.7)
Other	72 (21.4)	57 (20.7)	15 (24.2)	20 (26.3)	11 (11.3)
With cirrhosis	297 (88.1)	246 (89.5)	51 (82.3)	31 (40.8)	65 (67.0)
PLT (× 109/L)	145.2 ± 122.9	146.9 ± 133.7	137.6 ± 57.8	143.8 ± 70.6	150.8 ± 75.7
ALT (U/L)	39.9 ± 43.6	39.8 ± 41.8	40.4 ± 51.3	27.6 ± 17.8	73.2 ± 206.5
AST (U/L)	36.2 ± 38.9	36.4 ± 39.4	35.5 ± 36.8	35.1 ± 18.8	75.4 ± 260.9
ALB (g/L)	43.0 ± 4.5	43.2 ± 4.3	41.7 ± 5.2	40.4 ± 5.3	39.5 ± 5.3
TBIL (μmol/L)	14.7 ± 8.0	15.0 ± 8.2	13.3 ± 6.8	19.0 ± 12.2	26.3 ± 41.7
AKP (U/L)	80.9 ± 29.5	82.3 ± 30.7	74.0 ± 22.2	113.0 ± 90.7	124.0 ± 60.8
GGT (U/L)	75.4 ± 110.9	79.5 ± 119.0	55.3 ± 52.8	104.9 ± 118.8	84.8 ± 81.6

PLT: Platelet count; ALT: Alanine aminotransferase; AST: Aspartate transaminase; ALB: Albumin; TBIL: Total bilirubin; AKP: Alkaline phosphatase; GGT: Gamma-glutamyl transferase.

Table 2 Performance of arterial phase hyper-enhancement, washout, and capsule classification

Data sets and metrics	APHE	Washout	Capsule
Center 1
AUC	0.975	0.803	0.759
Sensitivity, %	94.4	85.0	76.5
Specificity, %	100.0	77.3	67.9
Accuracy, %	95.2	82.3	72.6
F1 score	0.971	0.861	0.754
Center 2
AUC	0.898	0.824	0.800
Sensitivity, %	89.0	90.9	68.2
Specificity, %	91.7	70.7	92.7
Accuracy, %	89.4	81.2	80.0
F1 score	0.935	0.833	0.779
Center 3
AUC	0.940	0.850	0.784
Sensitivity, %	91.6	80.0	73.2
Specificity, %	66.7	83.3	68.8
Accuracy, %	89.4	80.8	71.2
F1 score	0.941	0.865	0.732

APHE: Arterial phase hyper-enhancement; AUC: Area under the receiver operating characteristic curve.

Table 3 Performance of Liver Imaging Reporting and Data System category classification between grade 3 and combined grade 4/5

Data sets and metrics	AUC	Sensitivity, %	Specificity, %	Accuracy, %	F1 score
Center 1	0.918	97.9	85.7	95.2	0.969
Center 2	0.826	93.8	71.4	88.2	0.923
Center 3	0.861	92.1	80.0	90.4	0.943

AUC: Area under the receiver operating characteristic curve.

Table 4 Comparison of running time between evidence-based automated Liver Imaging Reporting and Data System grade 3, 4, and 5 categorization system and radiologists, mean ± SD

Data sets	Time of Evi-LIRADS (seconds per patient)	Time of radiologists (seconds per patient)
Center 1	6.6 ± 3.4	35.4 ± 15.1
Center 2	18.8 ± 22.6	31.8 ± 7.6
Center 3	18.8 ± 13.1	40.2 ± 16.1
Average for three centers	14.7	35.8

Evi-LIRADS: Evidence-based radiologist-supervised automated Liver Imaging Reporting and Data System.