The LI-RADS Version 2018 MRI Treatment Response Algorithm: Evaluation of Ablated Hepatocellular Carcinoma

Chaudhry, Mohammad Rauf A; McGinty, Katrina; Mervak, Benjamin M.; Lerebours, Reginald; Li, Cai; Shropshire, Erin; Ronald, James; Commander, Leah; Hertel, Johann; Luo, Sheng; Bashir, Mustafa R.; Burke, Lauren M.

doi:10.1148/radiol.2019191581

Cited by 61 publications

(62 citation statements)

References 14 publications

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“…Viable disease is described by nodular, mass-like, or thick irregular tissue in or along the treated lesion with arterial phase hyperenhancement, washout, or a similar enhancement pattern prior to treatment. 49 The degree of tumor response is measured with the AASLDrecommended modified Response Evaluation Criteria in Solid Tumors (mRECIST) or the EASL classification. 8,9 For recurrent or residual disease, the patient should be presented again at the multidisciplinary conference for determination for the next best treatment option (e.g., repeat same intervention after TACE, switch modalities to TARE or SBRT, or continue surveillance).…”

Section: Treatment Evaluationmentioning

confidence: 99%

Diagnosis, Staging, and Patient Selection for Locoregional Therapy to Treat Hepatocellular Carcinoma

Berman

Newton

2020

Semin intervent Radiol

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Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related mortality and the only cancer for which the incidence and mortality are on the rise. Sensitive and specific screening and diagnostic approaches, robust staging regimens, multidisciplinary tumor boards, and patient/family education and engagement in the shared decision-making process help to identify a patient's optimal treatment options. Locoregional therapies have been the mainstay for treating intermediate-stage disease, but they are finding special applications for early and advanced disease. This review discusses the diagnosis of HCC, current accepted staging models, and treatment of HCC, with a focus on locoregional therapies.

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Section: Treatment Evaluationmentioning

confidence: 99%

Diagnosis, Staging, and Patient Selection for Locoregional Therapy to Treat Hepatocellular Carcinoma

Berman

Newton

2020

Semin intervent Radiol

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“…Notwithstanding the importance of the diagnostic performance, it is essential that the LR-TR has high interreader reliability if it is to be used for determining treatment response and deciding on a proper management strategy in patients with HCC. Prior studies have reported on the interreader reliability of the LR-TR [10][11][12][13][14][15][16][17], but their results are subject to limitations because of their relatively small sample sizes and between-study variability in the reported data. Given the increased attention to LR-TR in clinical practice, we consider it timely and important to determine the interreader reliability of LR-TR and to understand any differences among the published studies.…”

Section: Introductionmentioning

confidence: 99%

Interreader Reliability of Liver Imaging Reporting and Data System Treatment Response: A Systematic Review and Meta-Analysis

et al. 2021

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Background: For a proper management strategy in patients with locoregionally treated hepatocellular carcinoma (HCC), it is essential that the Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (LR-TR) has high interreader reliability. We aimed to systematically evaluate the interreader reliability of LR-TR and sources of any study heterogeneity. Methods: Original studies reporting the interreader reliability of LR-TR were identified in MEDLINE and EMBASE up to 20 September 2020. The pooled kappa coefficient (κ) was calculated using the DerSimonian–Laird random effects model. Subgroup analyses were performed according to imaging modality (magnetic resonance imaging (MRI) or computed tomography (CT)). Meta-regression analyses were performed to explore study heterogeneity. Results: Eight studies with 851 HCCs were finally included. Pooled κ was 0.70 (95% CI, 0.58–0.82) for CT/MRI LR-TR, and those of MRI and CT were 0.71 (95% CI, 0.53–0.89) and 0.71 (95% CI, 0.65–0.78), respectively. Study design (p < 0.001) and type of treatment (p = 0.02) were significantly associated with substantial study heterogeneity. Conclusion: LR-TR showed substantial interreader reliability regardless of the imaging modality. Because of substantial study heterogeneity, which was significantly associated with study design and type of treatment, published values for the interreader reliability of LR-TR should be interpreted with care.

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“…It is important to prevent redundant follow-up, and therefore, interventional radiologists should make an effort to have a multidisciplinary follow-up protocol in their hospital in which it is clear who takes responsibility for follow-up. Last, thermal ablation of HCC was not discussed for which the LI-RADS treatment response algorithm is available [107].…”

Section: Limitationsmentioning

confidence: 99%

Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice

et al. 2020

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Interventional radiology plays an important and increasing role in cancer treatment. Follow-up is important to be able to assess treatment success and detect locoregional and distant recurrence and recommendations for follow-up are needed. At ECIO 2018, a joint ECIO-ESOI session was organized to establish follow-up recommendations for oncologic intervention in liver, renal, and lung cancer. Treatments included thermal ablation, TACE, and TARE. In total five topics were evaluated: ablation in colorectal liver metastases (CRLM), TARE in CRLM, TACE and TARE in HCC, ablation in renal cancer, and ablation in lung cancer. Evaluated modalities were FDG-PET-CT, CT, MRI, and (contrast-enhanced) ultrasound. Prior to the session, five experts were selected and performed a systematic review and presented statements, which were voted on in a telephone conference prior to the meeting by all panelists. These statements were presented and discussed at the ECIO-ESOI session at ECIO 2018. This paper presents the recommendations that followed from these initiatives. Based on expert opinions and the available evidence, follow-up schedules were proposed for liver cancer, renal cancer, and lung cancer. FDG-PET-CT, CT, and MRI are the recommended modalities, but one should beware of false-positive signs of residual tumor or recurrence due to inflammation early after the intervention. There is a need for prospective preferably multicenter studies to validate new techniques and new response criteria. This paper presents recommendations that can be used in clinical practice to perform the follow-up of patients with liver, lung, and renal cancer who were treated with interventional locoregional therapies.

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The LI-RADS Version 2018 MRI Treatment Response Algorithm: Evaluation of Ablated Hepatocellular Carcinoma

Cited by 61 publications

References 14 publications

Diagnosis, Staging, and Patient Selection for Locoregional Therapy to Treat Hepatocellular Carcinoma

Diagnosis, Staging, and Patient Selection for Locoregional Therapy to Treat Hepatocellular Carcinoma

Interreader Reliability of Liver Imaging Reporting and Data System Treatment Response: A Systematic Review and Meta-Analysis

Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice

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