The aim of our investigation is to assess the diagnostic accuracy of the LI-RADS 2017 criteria at two institutions using multiple readers with varying levels of experience with explant or imaging follow-up as the reference standard. Radiology databases from two academic institutions were searched (2013-2014) for patients with a clinical diagnosis of chronic liver disease and at least one reported hepatic observation on dynamic contrast enhanced CT or MRI. This yielded a final cohort of 103 patients with 141 hepatic observations. Two radiologists reviewed the imaging independently and assigned a LI-RADs category to each observation. Inter-reader reliability for LI-RAD assessment was moderate (ICC = 0.63). Sensitivity of LI-RADs categorization for diagnosing HCC was 62% and 59% and specificity was 96% and 84% for reader 1 and 2 respectively. LI-RADs categorization using gadoxetate disodium MR demonstrated higher specificity for HCC diagnosis for reader 2, than MR with extracellular agent.
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