Effect of threshold growth as a major feature on LI-RADS categorization

Chernyak, Victoria; Kobi, Mariya; Flusberg, Milana; Fruitman, Kate C.; Sirlin, Claude B.

doi:10.1007/s00261-017-1105-8

Cited by 14 publications

(14 citation statements)

References 36 publications

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“…This is not surprising as threshold growth has been shown to be a relatively minor driver of categorization; in a previously published study, only 9% of v2017 LR-5 observations would be down-categorized to LR-4 if threshold growth was removed as a MF. (9) The relevance of threshold growth may be even lower in v2018 as the presence of WO alone in a 10-19 mm observation with nonrim APHE suffices for LR-5 categorization. (4) There was 1 extreme case in our cohort that merits discussion.…”

Section: Discussionmentioning

confidence: 99%

“…Dynamic contrast‐enhanced CT examinations were performed on 64‐detector row scanners, and MRI examinations were performed on 1.5T and 3T scanners, with the details of the protocols and MR equipment summarized previously . All imaging studies met LI‐RADS minimal technical requirements …”

Section: Methodsmentioning

confidence: 99%

“…Dynamic contrast-enhanced CT examinations were performed on 64-detector row scanners, and MRI examinations were performed on 1.5T and 3T scanners, with the details of the protocols and MR equipment summarized previously. (9) All imaging studies met LI-RADS minimal technical requirements. (10) statistical analysis Cohort characteristics, observation features, and concordance between systems in assigning observation category and T stage were summarized descriptively.…”

Section: Imaging Techniquesmentioning

confidence: 99%

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Liver Imaging Reporting and Data System Version 2018: Impact on Categorization and Hepatocellular Carcinoma Staging

et al. 2019

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The purpose of this study was to assess the concordance in categorization and radiologic T staging using Liver Imaging Reporting and Data System (LI‐RADS, LR) version 2017 (v2017), version 2018 (v2018), and the Organ Procurement and Transplantation Network (OPTN) criteria. All magnetic resonance imaging and computed tomography reports using a standardized LI‐RADS macro between April 2015 and March 2018 were identified retrospectively. The major features (size, arterial phase hyperenhancement, washout, enhancing capsule, or threshold growth) were extracted from the report for each LR‐3, LR‐4, and LR‐5 observation. Each observation was assigned a new category based on LI‐RADS v2017, v2018, and OPTN criteria. Radiologic T stage was calculated based on the size and number of LR‐5 or OPTN class 5 observations. Categories and T stages assigned by each system were compared descriptively. There were 398 patients (66.6% male; mean age, 63.4 years) with 641 observations (median size, 14 mm) who were included. A total of 73/182 (40.1%) observations categorized LR‐4 by LI‐RADS v2017 were up‐categorized to LR‐5 by LI‐RADS v2018 due to changes in the LR‐5 criteria, and 4/196 (2.0%) observations categorized as LR‐5 by LI‐RADS v2017 were down‐categorized to LR‐4 by LI‐RADS v2018 due to changes in the threshold growth definition. The T stage was higher by LI‐RADS v2018 than LI‐RADS v2017 in 49/398 (12.3%) patients. Compared with the OPTN stage, 12/398 (3.0%) patients were upstaged by LI‐RADS v2017 and 60/398 (15.1%) by LI‐RADS v2018. Of 101 patients, 5 (5.0%) patients with T2 stage based on LI‐RADS v2017 and 10/102 (9.8%) patients with T2 stage based on LI‐RADS v2018 did not meet the T2 criteria based on the OPTN criteria. Of the 98 patients with a T2 stage based on OPTN criteria, 2 (2.0%) had a T stage ≥3 based on LI‐RADS v2017 and 6 (6.1%) had a T stage ≥3 based on LI‐RADS v2018.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Imaging Techniquesmentioning

confidence: 99%

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Liver Imaging Reporting and Data System Version 2018: Impact on Categorization and Hepatocellular Carcinoma Staging

et al. 2019

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“…Definite growth is defined by the CEUS LI-RADS core document as the unequivocal increase in size of a lesion; there is no established “threshold”, but >5 mm is generally considered unequivocal growth. Ultrasound should only be compared with ultrasound and the size increase should not be attributable to artifacts, measurement errors, or difference in technique [ 46 ].…”

Section: Major Featuresmentioning

confidence: 99%

CT/MRI LI-RADS v2018 vs. CEUS LI-RADS v2017—Can Things Be Put Together?

Caraiani

Boca

Bura

et al. 2021

Biology

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Different LI-RADS core documents were released for CEUS and for CT/MRI. Both documents rely on major and ancillary diagnostic criteria. The present paper offers an exhaustive comparison of the two documents focusing on the similarities, but especially on the differences, complementarity, and added value of imaging techniques in classifying liver nodules in cirrhotic livers. The major diagnostic criteria are defined, and the sensitivity and specificity of each major diagnostic criteria are presented according to the literature. The existing differences between techniques in assessing the major diagnostic features can be then exploited in order to ensure a better classification and a better clinical management of liver nodules in cirrhotic livers. Ancillary features depend on the imaging technique used, and their presence can upgrade or downgrade the LI-RADS score of an observation, but only as far as LI-RADS 4. MRI is the imaging technique that provides the greatest number of ancillary features, whereas CEUS has fewer ancillary features than other imaging techniques. In the final part of the manuscript, some recommendations are made by the authors in order to guidephysicians as to when adding another imaging technique can be helpful in managing liver nodules in cirrhotic livers.

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“…Unequivocal diameter increase refers to an increase in the maximum diameter of a nodule over time which is not attributable to an artifact, differences in technique or modality between the exams, or measurement error [13,20]. Importantly, only US findings can be compared to US findings; while MRI and CT findings can each be compared to the other modality, neither should be compared to US results.…”

Section: Unequivocal Diameter Increase (Growth)mentioning

confidence: 99%

LI-RADS ancillary features on contrast-enhanced ultrasonography

Dietrich

Kono

et al. 2020

Ultrasonography

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The Liver Imaging Reporting and Data System (LI-RADS) was created to standardize liver imaging in patients at high risk for hepatocellular carcinoma (HCC), and it uses a diagnostic algorithm to assign categories that reflect the relative probability of HCC, non-HCC malignancies, or benign focal liver lesions. In addition to major imaging features, ancillary features (AFs) are used by radiologists to refine the categorization of liver nodules. In the present document, we discuss and explain the application of AFs currently defined within the LI-RADS guidelines. We also explore possible additional AFs visible on contrast-enhanced ultrasonography (CEUS). Finally, we summarize the management of CEUS LI-RADS features, including the role of current and potential future AFs.

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Effect of threshold growth as a major feature on LI-RADS categorization

Abstract: 9% of LR-5 observations would be downgraded without TG.

Cited by 14 publications

References 36 publications

Liver Imaging Reporting and Data System Version 2018: Impact on Categorization and Hepatocellular Carcinoma Staging

Liver Imaging Reporting and Data System Version 2018: Impact on Categorization and Hepatocellular Carcinoma Staging

CT/MRI LI-RADS v2018 vs. CEUS LI-RADS v2017—Can Things Be Put Together?

LI-RADS ancillary features on contrast-enhanced ultrasonography

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