Geographic and Sex Distribution of LI-RADS Research Globally: A Cross-Sectional Meta-Research Study
BACKGROUND: Hepatocellular carcinoma (HCC) has an uneven global distribution and a higher incidence in males. The Liver Imaging Reporting and Data System (LI-RADS) is a standardized imaging framework for HCC diagnosis. It is unclear whether the evidence used to inform LI-RADS reflects the global burden of HCC. PURPOSE: To determine whether the geographic and sex distribution of studies assessing LI-RADS and those included in the LI-RADS individual participant data (IPD) database reflect the global burden of HCC. MATERIALS AND METHODS: We conducted a cross-sectional meta-research study comparing the country- and sex-specific HCC prevalence from GLOBOCAN 2022 with the distribution of studies eligible for and included in the LI-RADS IPD database. Studies were identified through a systematic search of 4 databases. STUDY PROTOCOL: . RESULTS: < .0001) compared to the global prevalence of HCC in females. CONCLUSION: LI-RADS research is disproportionately reported from some countries relative to HCC burden. Asia, Africa, and female patients remain underrepresented. This may affect the generalizability and diagnostic equity of the LI-RADS system and underscore the need for improved global inclusivity in LI-RADS research.
Authors
- Haresh Naringrekar (ORCID: https://orcid.org/0000-0003-1049-4457)
- Hala Mahdi (ORCID: https://orcid.org/0000-0003-2340-4609)
- Andreu F. Costa (ORCID: https://orcid.org/0000-0003-1683-8230)
- Justin Presseau (ORCID: https://orcid.org/0000-0002-2132-0703)
- Matthew D. F. McInnes (ORCID: https://orcid.org/0000-0001-8404-4075)
- Christian B. van der Pol (ORCID: https://orcid.org/0000-0002-1718-2619)
- Mostafa Alabousi (ORCID: https://orcid.org/0000-0003-4023-0559)
- Eric Lam (ORCID: https://orcid.org/0000-0002-0948-9506)
- Jean‐Paul Salameh (ORCID: https://orcid.org/0000-0002-4105-2056)
- Nabil Islam
- Rawan Awad
- An Tang
- Mustafa R. Bashir
- Hoda Osman (ORCID: https://orcid.org/0009-0004-4554-7963)
Institutions
- University of North Carolina at Chapel Hill (US)
- Dalhousie University (CA)
- University of Ottawa (CA)
- Thomas Jefferson University Hospital (US)
- Juravinski Cancer Centre (CA)
- Queen Elizabeth II Health Sciences Centre (CA)
- Ottawa Hospital (CA)
- Juravinski Hospital (CA)
- Duke Medical Center (US)
- William Osler Health System (CA)
- Ottawa Hospital Research Institute (CA)
- Université de Montréal (CA)
Publication Details
- Journal
- Canadian Association of Radiologists Journal
- Published
- 2026-04-12
- DOI
- https://doi.org/10.1177/08465371261429344
- Primary Topic
- Hepatocellular Carcinoma Treatment and Prognosis
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Radiological Society of North America
- Canadian Institutes of Health Research
- Fonds de Recherche du Québec - Santé