Evaluation of LI-RADS 3 category by magnetic resonance in US-detected nodules ≤ 2 cm in cirrhotic patients

Darnell, Anna; Rimola, Jordi; Belmonte, Ernest; Ripoll, Enric; García–Criado, Ángeles; Caparroz, Carla; Díaz-González, Álvaro; Vilana, R.; Reig, María; Ayuso, Carmen; Bruix, Jordi; Forner, Alejandro

doi:10.1007/s00330-020-07457-6

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…Rezente Metaanalysen, die Studien zu LI-RADS v2011, v2014 und v2017 inkludierten, konnten zeigen, dass der Anteil von HCC in der Kategorie LR-1 0 %, LR-2 4-13 %, LR-3 34-38 %, LR-4 67-74 % und in LR-5 92-94 % beträgt [12,13]. Dies bedeutet, dass bei einer Observation LR-1 oder LR-2 mit sehr hoher bis hoher Wahr- wurden, eine HCC-Prävalenz von 68,9 %, was bei LR-3 Befunden eine weitere, auch invasive Abklärung rechtfertigt [14].…”

Section: Lr-trunclassified

“…In category LR-3, repeat imaging or alternative imaging after only 3-6 months is consequently recommended to detect any increase in size (major feature: threshold growth ≥ 50 % in ≤ 6 months) or change in morphology [4]. A study by Darnell et al shows an HCC prevalence of 68.9 % in foci ≤ 2 cm newly discovered in ultrasound, which were then classified as LR-3 in MRI, which justifies further, also invasive clarification in the case of LR-3 findings [14].…”

Section: How Effective Li-rads For Diagnosing Hcc? How Effective Are ...mentioning

confidence: 99%

“…In der Kategorie LR-3 wird konsequenterweise eine Wiederholung der Bildgebung oder die Durchführung alternativer bildgebender Verfahren in nur 3–6 Monaten empfohlen, um eine eventuelle Größenzunahme (Hauptkriterium Schwellenwachstum ≥ 50 % in ≤ 6 Monaten) oder eine Änderung der Morphologie zu erfassen 4 . Eine Studie von Darnell et al zeigt bei im US neu entdeckten Herden ≤ 2 cm, die dann in der MRT als LR-3 klassifiziert wurden, eine HCC-Prävalenz von 68,9 %, was bei LR-3 Befunden eine weitere, auch invasive Abklärung rechtfertigt 14 .…”

Section: Li-rads-kategorienunclassified

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LI-RADS Made Easy

Schima

Kopf

Eisenhuber

2023

Rofo

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Purpose The Liver Imaging Reporting and Data System (LI-RADS v2018) standardizes the interpretation and reporting of MDCT and MRI examinations in patients at risk for hepatocellular carcinoma (HCC). Materials and Methods For focal liver lesions (called “observations”) it assigns categories (LR-1 to 5, LR-M, LR-TIV, LR-TR), which reflect the probability of benignity or malignancy (HCC or other non-HCC malignancies) of the respective observation. The categories assigned are based on major and ancillary image features, which have been developed by the American College of Radiology (ACR), revised several times (now v2018), and validated in many studies. The value of ancillary features to modify LI-RADS categories assigned to observations based on major features is shown. Results This review summarizes the relevant CT and MRI features and presents a step-by-step approach for readers not familiar with LI-RADS on how to use the system. Relevant imaging features and the value of different modalities (contrast-enhanced CT, MRI with extracellular gadolinium chelates or liver-specific contrast agents) is explained. Conclusion The widespread adoption of LI-RADS for CT/MRI reporting in high-risk patients would help to reduce inter-reader variability. It could improve communication between radiologists, oncologists, hepatologists, pathologists, and liver surgeons, and lead to better patient management. Key points: Citation Format

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Section: Lr-trunclassified

Section: How Effective Li-rads For Diagnosing Hcc? How Effective Are ...mentioning

confidence: 99%

Section: Li-rads-kategorienunclassified

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LI-RADS Made Easy

Schima

Kopf

Eisenhuber

2023

Rofo

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“…The common characteristic they share is that they are associated with chronic inflammation of the biliary epithelium and bile stasis [1,2] . For instance high alcohol consumption, presence and longer duration of inflammatory bowel disease (IBD) [48] , portal hypertension, cirrhosis, tobacco smoking, viral hepatitis, non-alcohol fatty liver disease (NAFLD), obesity, and metabolic syndrome are all risk factors for CCA [4,49] . Regrettably, although all those factors are associated with higher risk of CCA, particularly for the intrahepatic form (iCCA), the high prevalence of some of them in general population makes any attempt of surveillance no cost-effective.…”

Section: Surveillance In Other High-risk Patientsmentioning

confidence: 99%

Cholangiocarcinoma: early detection and screening in high-risk population

Muñoz-Martínez¹,

Rimola²,

Londoño³

et al. 2022

Hepatoma Res

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Cholangiocarcinoma (CCA) is a highly lethal malignancy that comprises approximately 15% of all the primary liver tumors and 3% of gastrointestinal cancers. Diagnosis is often done when the disease is already at advanced stages, resulting in poor outcomes. Prevention of risk factors and early diagnosis are the cornerstones for improving survival. Early diagnosis is feasible in the setting of surveillance programs in patients at high risk of CCA such as patients with primary sclerosing cholangitis. Regrettably, surveillance of CCA in this population is hampered by the low diagnostic accuracy of current tumor markers at earlier stages, the difficulties of imaging techniques for the differential diagnosis between benign and malignant biliary strictures, and the need for invasive procedures for diagnostic confirmation. In this review we discuss the rationale for surveillance of CCA in high-risk populations, particularly patients with primary sclerosing cholangitis, the recommended tools for surveillance and diagnostic work-up, and future perspectives.

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“…Plasma samples were treated with Triton™ X-100 (1%) for virus inactivation [27]. Immune mediator levels were measured using Cytokine/Chemokine/Growth Factor 45-Plex Human ProcartaPlex™ Panel 1 (ThermoFisher Scienti c, Waltham, MA, USA).…”

Section: Multiplex Microbead-based Immunoassaymentioning

confidence: 99%

Dynamic Alterations of Anti-S-Protein Igg Subclasses and of Th1/Th2 Responses are Hallmarks of Acute Severe COVID-19 Disease

Goh

Fong

Amrun

et al. 2021

Preprint

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PurposeCOVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), has a wide disease spectrum ranging from asymptomatic to severe. While it is widely accepted that specific humoral immune responses are critical in controlling the infection, the relationship between the humoral immune response and disease severity is currently unclear.MethodsUsing a flow cytometry-based assay to detect specific antibodies against full length S protein, we compared the antibody levels between patients from different severity groups. We also analysed the cytokine profiles of patients from different severity groups by multiplex microbead-based immunoassay.ResultsWe found an association between specific IgM, IgA and IgG against the spike protein and disease severity. By comparing the ratio of Th1 IgG1 and IgG3 to Th2 IgG2 and IgG4, we observed that all severity groups exhibited a ratio that was skewed towards a stronger Th1 response over Th2 response. In addition to the strong Th1 response, patients with severe disease also developed a Th2 response, as exemplified by the smaller ratio of IgG1 and IgG3 over IgG2 and IgG4 and the smaller Th1/Th2 cytokine ratios, compared to patients with mild disease severity. ConclusionThe results suggest that acute severity or disease resolution is associated with a specific immunological phenotype. A smaller skew towards a Th1 response over Th2 response, during infection, may contribute to disease progression, while a greater skew towards a Th1 response over Th2 response may contribute to a better disease outcome. This may suggest potential therapeutic approaches to COVID-19 disease management.

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Evaluation of LI-RADS 3 category by magnetic resonance in US-detected nodules ≤ 2 cm in cirrhotic patients

Cited by 10 publications

References 29 publications

LI-RADS Made Easy

LI-RADS Made Easy

Cholangiocarcinoma: early detection and screening in high-risk population

Dynamic Alterations of Anti-S-Protein Igg Subclasses and of Th1/Th2 Responses are Hallmarks of Acute Severe COVID-19 Disease

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