LI-RADS v2018 versus KLCA-NCC v2022: comparison of probability-based HCC categories

To compare the probability of hepatocellular carcinoma (HCC) across corresponding categories of LI-RADS v2018 and KLCA-NCC v2022.

Study Design: A retrospective multicenter study involving eleven tertiary hospitals in South Korea.
Eligibility Criteria: Included HCC-naïve patients with chronic hepatitis B or C, or cirrhosis, who underwent gadoxetic acid-enhanced MRI.
Image Acquisition: MRI and CT scans were performed using standard protocols with specific imaging sequences.
Image Analysis: Four radiologists independently reviewed tumors and assigned LI-RADS and KLCA-NCC categories.
Statistical Analysis: Diagnostic performance was assessed using generalized estimating equations (GEE) and interobserver agreement was evaluated.

LI-RADS v2018 and KLCA-NCC v2022 categorize HCC probability using different major features and ancillary features.
Both systems include categories for definite HCC, probable HCC, and indeterminate nodules.
Limited evidence exists supporting the equivalence of categories between the two systems due to distinct diagnostic criteria.

The study is retrospective and may be subject to selection bias.
The diagnostic criteria for LI-RADS and KLCA-NCC differ, complicating direct comparisons.