LI-RADS v2024 radiation response algorithm: high specificity, low sensitivity for viable tumor after Y-90

For hepatocellular carcinoma after Y-90 radioembolization, LR-TR-Viable had 16.3% sensitivity (95% CI 10.1-25.2%) and 92.9% specificity (95% CI 88.2-95.8%) for viable tumor on explant. Inter-reader agreement for viability was low (ICC 0.269).

• For 124 observations, 66.4% were LR-TR-Nonviable, 25.5% Nonprogressing, and 7.5% Viable. Overall pairwise agreement was 89.8% (CT 88.7%, MRI 91.2%).
• Pathologic viability rates were 31.2% (Nonviable), 42.1% (Nonprogressing), and 53.6% (Viable) (p=0.02).
• LR-TR-Viable vs Nonviable had odds ratio 2.55 (95% CI 1.16-5.62) for viable tumor.

Automated summary

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