2017 Version of LI-RADS for CT and MR Imaging: An Update

Elsayes, Khaled M.; Hooker, Jonathan; Agrons, Michelle M.; Kielar, Ania Z.; Tang, An; Fowler, Kathryn J.; Chernyak, Victoria; Bashir, Mustafa R.; Kono, Yuko; Richard, K. G.; Mitchell, Donald G.; Kamaya, Aya; Hecht, Elizabeth M.; Sirlin, Claude B.

doi:10.1148/rg.2017170098

Cited by 205 publications

(169 citation statements)

References 42 publications

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“…A total of 191 patients underwent liver biopsy before treatment, and F0‐1/F2/F3/F4 stages of fibrosis were found in 75/47/48/21 cases, respectively. Fifteen patients had liver nodules with intermediate probability of HCC (LR3) or probably of HCC (LR4) as defined by liver imaging reporting and data system (LI‐RADS) at entry . The mean observation period was 26.4 ± 7.9 months, and 24 patients developed HCC during the observation period.…”

Section: Resultsmentioning

confidence: 99%

Risk assessment of hepatocellular carcinoma development by magnetic resonance elastography in chronic hepatitis C patients who achieved sustained virological responses by direct‐acting antivirals

Tamaki

Higuchi

Kurosaki

et al. 2019

Journal of Viral Hepatitis

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Prediction of hepatocellular carcinoma (HCC) development after sustained virological response (SVR) is clinically important, and the usefulness of noninvasive markers for prediction HCC have been reported. The aim of this study was to compare the prediction accuracy for HCC development by noninvasive markers. A total of 346 patients with chronic hepatitis C without history of HCC who achieved SVR through direct‐acting antivirals were included. Magnetic resonance elastography (MRE) and serum fibrosis markers were measured 12 weeks after the end of treatment, and the subsequent HCC development was examined. The mean observation period was 26.4 ± 7.9 months, and 24 patients developed HCC. Area under the receiver operating characteristic curve of liver stiffness by MRE, Wisteria floribunda agglutinin‐positive mac‐2 binding protein and FIB‐4 for predicting HCC within 3 years was 0.743, 0.697 and 0.647, respectively. The 1/2/3‐year rates of HCC development in patients with liver stiffness ≥3.75 KPa were 6.6%, 11.9% and 14.5%, whereas they were 1.4%, 2.5% and 2.5% in patients with liver stiffness <3.75 KPa (P < 0.001). Multivariate analysis revealed that liver stiffness ≥3.75 was an independent predictive factor for HCC development (hazard ratio, 3.51; 95% confidence interval, 1.24‐9.99). In subgroup analysis, there were 132 patients who were <73 years old and had liver stiffness <3.75 KPa, and no HCC development was observed in these patients. Diagnostic accuracy for predicting HCC development was higher in MRE than serum fibrosis markers and measurement of liver stiffness by MRE could identify patients with high and low risk of HCC development after SVR.

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Section: Resultsmentioning

confidence: 99%

Risk assessment of hepatocellular carcinoma development by magnetic resonance elastography in chronic hepatitis C patients who achieved sustained virological responses by direct‐acting antivirals

Tamaki

Higuchi

Kurosaki

et al. 2019

Journal of Viral Hepatitis

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“…Baseline tumor characteristics were noted, including number, size, location according to the Couinaud classification system, arterial hyperenhancement when compared to the surrounding liver (absent, homogeneous, or heterogeneous), and presence of fat, defined as excess fat within a tumor, in whole or in part, relative to the adjacent liver, 26 as well as infrasegmental PVT. Details of CT and MR protocols are provided in Supporting Information.…”

Section: Methodsmentioning

confidence: 99%

Influence of pretreatment tumor growth rate on objective response of hepatocellular carcinoma treated with transarterial chemoembolization

Purcell

Sartoris

Paradis

et al. 2019

J of Gastro and Hepatol

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Background and Aim The study aims to assess the influence of pretreatment tumor growth rate (TGR) on modified response evaluation criteria in solid tumors (mRECIST) objective response (OR) after a first session of selective transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Methods One hundred fifteen patients (101 men [88%], mean 65.1 ± 10.5 years [range 26–87]) with 169 tumors (mean 34.2 ± 29.3 mm [10–160]), undergoing a first session of selective TACE for the treatment of HCC between 2011 and 2016, were included. TGR was calculated as the percentage change in tumor volume per month (%/month) on imaging before treatment. TGR cut‐off for prediction of OR was identified by receiver operating characteristic curve analysis. Results Overall 88/189 (52%) and 46/189 (27%) tumors showed complete response (CR) and partial response (PR) (OR rate 79%), while 32/189 (19%) showed stable disease (SD), and 3/189 (2%) were progressive disease (PD) on computed tomography at 1‐month post‐TACE. The mean pretreatment TGR was 12.0 ± 15.4 (−3.2–90.4) %/month. TGR of tumors showing CR, PR, SD, and PD was a mean 13.2 ± 16.4%, 12.1 ± 15.1%, 5.3 ± 4.5%, and 44.8 ± 20.4%, respectively (P < 0.001). The three tumors showing PD had TGR values > 20%/month. TGR was significantly higher in tumors with OR (12.8 ± 15.9% vs 5.3 ± 4.5% in SD, P = 0.009). A cut‐off value of 6.5%/month had the highest predictive value of OR (AUROC 0.65 ± 0.05, P = 0.009). Conclusion Pretreatment TGR is highly variable in HCC before TACE with a U‐shaped distribution for the prediction of tumor response. It provides insight into tumor biology that may be used during pretreatment workup to help stratify patients.

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“…AS THE MOST COMMON primary liver neoplasm, hepatocellular carcinoma (HCC) is the sixth most common cancer and the fourth leading cause of cancer‐related deaths worldwide in 2018 . If diagnosed at an early stage, HCC can be treated with resection, percutaneous ablation, or orthotopic liver transplantation, and the 5‐year survival rate can be as high as more than 50% . For HCC diagnosis, imaging plays a critical role, especially for multiphase contrast‐enhanced computed tomography (CT) and magnetic resonance imaging (MRI) .…”

mentioning

confidence: 99%

Diagnostic performance of MR for hepatocellular carcinoma based on LI‐RADS v2018, compared with v2017

Ren

Zhao

Yang

et al. 2019

Magnetic Resonance Imaging

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Background The Liver Imaging Reporting and Data System (LI‐RADS) is widely adopted for noninvasive diagnosis of hepatocellular carcinoma (HCC). It's updated to version 2018 recently, with some major changes compared with v2017. However, the diagnostic performance of LI‐RADS v2018 and its difference with v2017 are yet to be validated. Purpose To compare the diagnostic performances of LI‐RADS on MR for diagnosing HCC between v2017 and v2018. Study Type Retrospective. Subjects In all, 181 patients with 217 hepatic observations (146 HCCs, 16 non‐HCC malignancies and 55 benign lesions) with liver MRI and pathological or follow‐up imaging diagnoses. Field Strength/Sequence 1.5 T or 3 T MRI. Dual‐echo T1WI, T2WI, diffusion‐weighted imaging, and a liver acquisition with volume acceleration. AssessmentImages were independently interpreted by three radiologists, and then in consensus for observations with different LR categories, according to LI‐RADS v2017 and v2018, separately. Statistical Tests Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+LR), and Youden index. Results When adopting LR‐5 as a predictor of HCC, the sensitivity (80.8% vs. 71.2%), NPV (69.6% vs. 60.7%), and accuracy (83.9% vs. 77.9%) were all increased for LI‐RADS v2018 compared with v2017, with a greater Youden index (0.709 vs. 0.627). However, the diagnostic performances of MRI for diagnosing HCC were not changed while adopting LR‐4/5 as a predictor. The threshold growths of 76% (19/25) observations in v2017 were revised to subthreshold growth in v2018, and 16 LR‐4 observations in v2017 were changed to LR‐5 based on v2018. Data Conclusion The diagnostic performance of LI‐RADS v2018 for diagnosing HCC is superior to v2017, with a greater sensitivity, NPV, and accuracy. The revisions in v2018 mainly affect the categorization when adopting LR‐5 as a predictor of HCC. Level of Evidence: 4 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:746–755.

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2017 Version of LI-RADS for CT and MR Imaging: An Update

Cited by 205 publications

References 42 publications

Risk assessment of hepatocellular carcinoma development by magnetic resonance elastography in chronic hepatitis C patients who achieved sustained virological responses by direct‐acting antivirals

Risk assessment of hepatocellular carcinoma development by magnetic resonance elastography in chronic hepatitis C patients who achieved sustained virological responses by direct‐acting antivirals

Influence of pretreatment tumor growth rate on objective response of hepatocellular carcinoma treated with transarterial chemoembolization

Diagnostic performance of MR for hepatocellular carcinoma based on LI‐RADS v2018, compared with v2017

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