LI-RADS to categorize liver nodules in patients at risk of HCC: tool or a gadget in daily practice?
Aged
Algorithms
Carcinoma, Hepatocellular
/ diagnostic imaging
Diagnosis, Differential
Female
Humans
Image Enhancement
Image Interpretation, Computer-Assisted
Liver Neoplasms
/ diagnostic imaging
Magnetic Resonance Imaging
Male
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed
Hepatocellular carcinoma
Liver
Liver reporting and data system
Magnetic resonance
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
20
04
2020
accepted:
12
05
2020
pubmed:
28
5
2020
medline:
23
2
2021
entrez:
28
5
2020
Statut:
ppublish
Résumé
To determine the effectiveness of liver reporting and data system (LI-RADS) to diagnose hepatocellular carcinoma (HCC) and to retrospectively evaluate its impact on the adopted therapeutic strategy. Preoperative imaging of 40 of 350 patients (median age 66, 31 M/9 F) submitted to liver resection for suspected HCC, between January 2008 and August 2019, has been retrospectively analyzed by two radiologists with different expertise, according to CT/MRI LI-RADS The perfect agreement between the readers was about 62.5% (25/40) (Cohen k: 0.41), better for LR-5 category (16/25) and higher in magnetic resonance imaging (MRI) investigations (68%; 13/19), which has been demonstrated the modality of choice for diagnosis of high probable and certain HCC, with arterial phase hyperenhancement as the most sensitive and accurate major feature. Compared to final histology, LR4 and LR5 scores assigned by senior radiologist reached sensitivity, specificity, positive and negative predictive values (PPV, PNV) and diagnostic accuracy of 90,9%, 29,0%, 93,8%, 62,5% and 87,5%, respectively, slightly higher than junior's ones. Misdiagnosis of HCC was done by both radiologists in the same two patients: 1 primary hepatic lymphoma (PHL) and 1 regenerative liver nodule (RLN). If LI-RADS would have been applied at the time of pre-surgical imaging, treatment planning would be modified in 10% of patients (4/40); the patient scheduled as LR-3 and finally resulted a focal nodular hyperplasia would have avoided liver resection. Application of LI-RADS, especially on MRI, may provide a more accurate evaluation of suspected HCC. PHL and RLN are the Achille's heels according to our experience.
Identifiants
pubmed: 32458272
doi: 10.1007/s11547-020-01225-8
pii: 10.1007/s11547-020-01225-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5-13Références
CT/MRI LI-RADS
Elsayes Khaled M et al (2019) LI-RADS: a conceptual and historical review from its beginning to its recent integration into AASLD clinical practice guidance. J Hepatocell Carcinoma. 6:49–69
doi: 10.2147/JHC.S186239
Mittal S, El-Serag HB (2013) Epidemiology of HCC: consider the population. J Clin Gastroenterol 40:S2–S6
doi: 10.1097/MCG.0b013e3182872f29
Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, Zhu AX, Murad MH, Marrero JA (2018) AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 67(1):358–380
doi: 10.1002/hep.29086
Petrick JL, Kelly SP, Altekruse SF, McGlynn KA, Rosenberg PS (2016) Future of hepatocellular carcinoma incidence in the United States forecast through 2030. J Clin Oncol 34(15):1787
doi: 10.1200/JCO.2015.64.7412
Navin PJ, Venkatesh SK (2019) Hepatocellular carcinoma: State of the art imaging and recent advances. J Clin Transl Hepatol. 7(1):72
doi: 10.14218/JCTH.2018.00032
Ayuso C, Rimola J, Vilana R, Burrel M, Darnell A, García-Criado Á, Bianchi L, Belmonte E, Caparroz C, Barrufet M, Bruix J (2018) Diagnosis and staging of hepatocellular carcinoma (HCC): current guidelines. Eur J Radiol 101:72–81
doi: 10.1016/j.ejrad.2018.01.025
“Cancer statistics, 2013”. Siegel R, Naishadham D, Jemal A; CA Cancer J Clin 2013;63:11–30
Carvalho PB, Pereira E (2015) Imagiological diagnosis of gastrointestinal diseases–diagnostic criteria of hepatocellular carcinoma. GE Port J Gastroenterol 22(4):153–160
doi: 10.1016/j.jpge.2015.04.002
Kim JH, Joo I, Lee JM (2019) Atypical appearance of hepatocellular carcinoma and its mimickers: how to solve challenging cases using gadoxetic acid-enhanced liver magnetic resonance imaging. Korean J Radiol 20:1019–1041
doi: 10.3348/kjr.2018.0636
Mehta N, Dodge JL, Roberts JP, Hirose R, Yao FY (2017) Misdiagnosis of hepatocellular carcinoma in patients receiving no local-regional therapy prior to liver transplant: an analysis of the organ procurement and transplantation network explant pathology form. Clin Transpl 31:e13107
doi: 10.1111/ctr.13107
Freeman RB, Mithoefer A, Ruthazer R, Nguyen K, Schore A, Harper A, Edwards E (2006) Optimizing staging for hepatocellular carcinoma before liver transplantation: a retrospective analysis of the UNOS/OPTN database. Liver Transpl 12:1504–1511
doi: 10.1002/lt.20847
Siedlikowski ST, Kielar AZ, Ormsby EL, Bijan B, Kagay C (2018) Implementation of LI-RADS into a radiological practice. Abdom Radiol 43:179–184
doi: 10.1007/s00261-017-1219-z
Lee JH, Lee JM, Kim SJ, Baek JH, Yun SH, Kim KW, Han JK, Choi BI (2012) Enhancement patterns of hepatocellular carcinomas on multiphasic multidetector row CT: comparison with pathological differentiation. Br J Radiol 85:e573–e583
doi: 10.1259/bjr/86767895
Davenport MS, Khalatbari S, Liu PS, Maturen KE, Kaza RK, Wasnik AP, Al-Hawary MM, Glazer DI, Stein EB, Patel J, Somashekar DK (2014) Repeatability of diagnostic features and scoring systems for hepatocellular carcinoma by using MR imaging. Radiology 272:132–142
doi: 10.1148/radiol.14131963
Tang A, Bashir MR, Corwin MT, Cruite I, Dietrich CF, Do RK, Ehman EC, Fowler KJ, Hussain HK, Jha RC, Karam AR (2018) Evidence supporting LI-RADS major features for CT-and MR imaging–based diagnosis of hepatocellular carcinoma: a systematic review. Radiology 286:29–48
doi: 10.1148/radiol.2017170554
Fraum TJ, Tsai R, Rohe E, Ludwig DR, Salter A, Nalbantoglu I, Heiken JP, Fowler KJ (2018) Differentiation of hepatocellular carcinoma from other hepatic malignancies in patients at risk: diagnostic performance of the liver imaging reporting and data system version 2014. Radiology 286:158–172
doi: 10.1148/radiol.2017170114
Liu W, Qin J, Guo R, Xie S, Jiang H, Wang X, Kang Z, Wang J, Shan H (2018) Accuracy of the diagnostic evaluation of hepatocellular carcinoma with LI-RADS. Acta Radiol 59:140–146
doi: 10.1177/0284185117716700
Tomasian A, Sandrasegaran K, Elsayes KM, Shanbhogue A, Shaaban A, Menias CO (2015) Hematologic malignancies of the liver: spectrum of disease. Radiographics 35:71–86
doi: 10.1148/rg.351130008
Leite NP, Kased N, Hanna RF, Brown MA, Pereira JM, Cunha R, Sirlin CB (2007) Cross-sectional imaging of extranodal involvement in abdominopelvic lymphoproliferative malignancies. Radiographics. 27:1613–1634
doi: 10.1148/rg.276065170
Elsayes KM, Menias CO, Willatt JM, Pandya A, Wiggins M (2009) Primary hepatic lymphoma: imaging findings. J Med Imaging Radiat Oncol 53:373–379
doi: 10.1111/j.1754-9485.2009.02081.x
Bach AG, Behrmann C, Holzhausen HJ, Spielmann RP, Surov A (2012) Prevalence and imaging of hepatic involvement in malignant lymphoproliferative disease. Clin Imaging 36:539–546
doi: 10.1016/j.clinimag.2012.01.027
Matsumoto S, Mori H, Takaki H, Ishitobi F, Shuto R, Yokoyama S (2004) Malignant lymphoma with tumor thrombus in the portal venous system. Abdom Imaging 29:460–462
doi: 10.1007/s00261-003-0138-3
Kaneko K, Nishie A, Arima F, Yoshida T, Ono K, Omagari J, Honda H (2011) A case of diffuse-type primary hepatic lymphoma mimicking diffuse hepatocellular carcinoma. Ann Nucl Med 25:303–307
doi: 10.1007/s12149-010-0460-0
De Gaetano AM, Rufini V, Castaldi P, Gatto AM, Filograna L, Giordano A, Bonomo L (2012) Clinical applications of 18 F-FDG PET in the management of hepatobiliary and pancreatic tumors. Abdom Imaging 37:983–1003
doi: 10.1007/s00261-012-9845-y
Bohlok A, De Grez T, Bouazza F, De Wind R, El-Khoury M, Repullo D, Donckier V (2018) Primary hepatic lymphoma mimicking a hepatocellular carcinoma in a cirrhotic patient: case report and systematic review of the literature. Case Rep Surg 2018:9183717
pubmed: 29850362
pmcid: 5914115
Jha RC, Mitchell DG, Weinreb JC, Santillan CS, Yeh BM, Francois R, Sirlin CB (2014) LI-RADS categorization of benign and likely benign findings in patients at risk of hepatocellular carcinoma: a pictorial atlas. Am J Roentgenol 203:W48–W69
doi: 10.2214/AJR.13.12169
Forner A, Vilana R, Ayuso C, Bianchi L, Solé M, Ayuso JR, Boix L, Sala M, Varela M, Llovet JM, Brú C (2008) Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology 47:97–104
doi: 10.1002/hep.21966
Choi JY, Lee JM, Sirlin CB (2014) CT and MR Imaging diagnosis and staging of hepatocellular carcinoma: part II Extracellular agents, hepatobiliary agents, and ancillary imaging features. Radiology 273:30–50
doi: 10.1148/radiol.14132362
Sano K, Ichikawa T, Motosugi U, Sou H, Muhi AM, Matsuda M, Nakano M, Sakamoto M, Nakazawa T, Asakawa M, Fujii H (2011) Imaging study of early hepatocellular carcinoma: usefulness of gadoxetic acid–enhanced MR imaging. Radiology 261:834–844
doi: 10.1148/radiol.11101840
Rhee H, Kim MJ, Park MS, Kim KA (2012) Differentiation of early hepatocellular carcinoma from benign hepatocellular nodules on gadoxetic acid-enhanced MRI. Br J Radiol 85:e837–e844
doi: 10.1259/bjr/13212920
Kim YK, Lee WJ, Park MJ, Kim SH, Rhim H, Choi D (2012) Hypovascular hypointense nodules on hepatobiliary phase gadoxetic acid–enhanced MR images in patients with cirrhosis: potential of DW imaging in predicting progression to hypervascular HCC. Radiol. 265:104–114
doi: 10.1148/radiol.12112649
Adachi T, Eguchi S (2014) Lymph node dissection for intrahepatic cholangiocarcinoma: a critical review of the literature to date. J Hepato-Biliary-Pancreatic Sci 21:162–168
doi: 10.1002/jhbp.30