Assessment of primary liver carcinomas other than hepatocellular carcinoma (HCC) with LI-RADS v2018: comparison of the LI-RADS target population to patients without LI-RADS-defined HCC risk factors

Fraum, Tyler J.; Cannella, Roberto; Ludwig, Daniel; Tsai, Richard; Naeem, Muhammad; LeBlanc, Maverick; Salter, Amber; Tsung, Allan; Shetty, Anup S.; Borhani, Amir A.; Furlan, Alessandro; Fowler, Kathryn J.

doi:10.1007/s00330-019-06448-6

Cited by 14 publications

(16 citation statements)

References 39 publications

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“…Previous studies have reported the proportion of cHCC‐CCAs categorized as LR‐M to vary between 61.4% and 93.9% 8‐10,21,22 . Our study results, with 67.3% of cHCC‐CCAs categorized as LR‐M, also fell within this range 8‐10,21,22 .…”

Section: Discussionsupporting

confidence: 75%

Clinicopathologic and MRI features of combined hepatocellular‐cholangiocarcinoma in patients with or without cirrhosis

Yoon

Hwang

Lee

et al. 2021

Liver International

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Background and Aims Differences in combined hepatocellular‐cholangiocarcinomas (cHCC‐CCAs) arising in high‐risk patients with or without liver cirrhosis have not been elucidated. This study aimed to compare the clinicopathologic and imaging characteristics of cHCC‐CCAs in patients with or without cirrhosis and to determine the prognostic factors for recurrence‐free survival (RFS) after curative resections of single cHCC‐CCAs. Methods This retrospective study included 113 patients with surgically resected single cHCC‐CCAs who underwent preoperative magnetic resonance imaging from January 2008 to December 2019 at two tertiary referral centres. Clinical, pathologic and imaging features of tumours were compared in high‐risk patients with or without cirrhosis. Imaging features were assessed using the Liver Imaging Reporting and Data System (LI‐RADS) version 2018. RFS and associated factors were evaluated using Cox proportional hazards regression analysis, Kaplan‐Meier analysis and log‐rank test. Results cHCC‐CCAs arising from cirrhotic livers had a smaller mean tumour size (2.9 cm vs. 4.5 cm; P < .001) and were more frequently categorized as LR‐5 or 4 (41.2% vs. 20.0%; P = .024) than those arising from non‐cirrhotic livers. In multivariable analysis, a tumour size of > 3 cm (hazard ratio [HR], 2.081; 95% confidence interval [CI], 1.180‐3.668; P = .011) and the LR‐M category (HR, 2.302; 95% CI, 1.198‐4.424; P = .012) were independent predictors associated with worse RFS. Conclusions The tumour size and distribution of LI‐RADS categories of cHCC‐CCAs differed in high‐risk patients with or without cirrhosis. And LR‐M category was a worse prognosis predictor after curative resections than LR‐5 or 4 category.

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Section: Discussionsupporting

confidence: 75%

Clinicopathologic and MRI features of combined hepatocellular‐cholangiocarcinoma in patients with or without cirrhosis

Yoon

Hwang

Lee

et al. 2021

Liver International

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“…The absence of exclusion criteria for rim‐like APHE could affect the specificity of noninvasive HCC diagnoses in imaging studies 42 . Additionally, according to recent studies in LI‐RADS v2018, interobserver agreements for LR‐5 criteria (nonrim APHE) and LR‐M criteria (rim APHE) were reported to be 0.56–0.6 39 and 0.21–0.48, 43 respectively; therefore, further refinement of the lexicon for imaging features is warranted in order to improve interobserver agreements.…”

Section: Liver Cancermentioning

confidence: 99%

“…Consequently, non‐HCC PLCs were more often miscategorized as probable or definite HCC in patients with risk factors. Therefore, in patients at high risk for HCC, differentiating small IMCC from HCC on dynamic MRI can be very difficult 43 . In terms of prognosis, IMCCs with nonrim APHE are associated with favorable surgical outcomes 85 .…”

Section: Liver Cancermentioning

confidence: 99%

“…As the targetoid appearance on HBP or DWI means peripheral hypercellularity, 6 it would be reasonable to identify the arterial phase enhancement pattern as rim APHE. However, great caution is required when radiologists evaluate nonrim APHE in the setting of an HCC diagnosis since interreader agreement is far from excellent 43,73 …”

Section: Liver Cancermentioning

confidence: 99%

“…To manage cirrhotic patients with focal liver lesions, although it is critical to precisely characterize focal liver lesions and stage liver malignancies, it remains quite challenging for radiologists to confidently deliver a diagnosis of HCC on MRI owing to the aforementioned issues, such as overlapped enhancing features of small tumors, atypical non‐HCC malignancies, or benign mimickers, especially in patients with risk factors for HCC 43 …”

Section: Liver Cancermentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of Primary Liver Cancers Using Hepatocyte‐Specific Contrast‐Enhanced MRI: Pitfalls and Potential Tips

Kim

Yoon

Joo

et al. 2020

Magnetic Resonance Imaging

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When radiologists interpret hepatic focal lesions seen on dynamic magnetic resonance imaging (MRI) scans, it is important not only to distinguish malignant lesions from benign ones but also to distinguish nonhepatocellular carcinoma (HCC) malignancies from HCCs. In addition, most major guidelines, including those of the American Association for the Study of Liver Disease, European Association for the Study of the Liver, and Korean Liver Cancer Association and National Cancer Center, allow for the noninvasive imaging diagnosis of HCC in at‐risk patients. However, ~40% of HCC cases show atypical imaging features mimicking non‐HCC malignancies. Furthermore, several benign and malignant lesions, such as flash‐filling hemangioma and intrahepatic mass‐forming cholangiocarcinoma, frequently look like HCC. In contrast, although multiparametric MRI options, including hepatobiliary phase and diffusion‐weighted imaging, provide useful information that could help address these challenges, there remain several unresolved issues with regard to the noninvasive diagnostic criteria characterizing HCC. In this article, we discuss the typical imaging features and challenging situations related to primary liver cancers in MRI, while considering how to make a correct diagnosis. Level of Evidence 5 Technical Efficacy Stage 3

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Targetoid appearance on T2-weighted imaging and signs of tumor vascular involvement: diagnostic value for differentiating HCC from other primary liver carcinomas

et al. 2021

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Assessment of primary liver carcinomas other than hepatocellular carcinoma (HCC) with LI-RADS v2018: comparison of the LI-RADS target population to patients without LI-RADS-defined HCC risk factors

Cited by 14 publications

References 39 publications

Clinicopathologic and MRI features of combined hepatocellular‐cholangiocarcinoma in patients with or without cirrhosis

Clinicopathologic and MRI features of combined hepatocellular‐cholangiocarcinoma in patients with or without cirrhosis

Evaluation of Primary Liver Cancers Using Hepatocyte‐Specific Contrast‐Enhanced MRI: Pitfalls and Potential Tips

Targetoid appearance on T2-weighted imaging and signs of tumor vascular involvement: diagnostic value for differentiating HCC from other primary liver carcinomas

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