Summary
This study aimed to evaluate the efficacy of the modified contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) in distinguishing malignancy in patients without known hepatocellular carcinoma (HCC) risk factors.
The modified CEUS LI-RADS, including the downgrading of focal nodular hyperplasia with typical features, demonstrated optimal performance (LR-5 + M) with a sensitivity of 99.3%, specificity of 81.6%, and an area under the curve (AUC) of 0.904. Novice radiologists using the modified CEUS LI-RADS outperformed those using the World Federation for Ultrasound in Medicine and Biology (WFUMB) guideline.
Moreover, the diagnostic performance of novices with the modified CEUS LI-RADS was comparable to that of experienced radiologists, highlighting its value, especially for those with limited CEUS expertise.
