AI Article Synopsis
- The study aimed to estimate how often different LI-RADS v2018 categories are reported in CT or MRI exams for screening hepatocellular carcinoma (HCC).
- It included 329 patients, with many receiving various types of MRIs and CT scans, finding that 60% had no liver observations and 6% had likely malignant findings.
- The results can guide the development of screening criteria and evaluate the cost-effectiveness of using CT and MRI for HCC surveillance.
Article Abstract
Purpose: To estimate the prevalence of Liver Imaging Reporting and Data System (LI-RADS, LR) v2018 categories reported on CT or MRI performed for hepatocellular carcinoma (HCC) screening.
Materials And Methods: This retrospective study included all reports for CT and MRI exams performed for HCC screening patients between 8/2018 and 4/2020. Patients with ultrasound, CT, or MRI of the abdomen within two years of the index exam were excluded. From each radiology report, we extracted number of reported liver observations, and LI-RADS v2018 category for each observation.
Results: There were 329 patients (170 [52%] male, mean age 59 years [SD 12]), of whom 177 (54%) had MRI with gadoxetate, 72 (22%) had MRI with extracellular contrast, 7 (2%) had MRI with unspecified contrast, and 73 (22%) had CT. Of 329 patients, 199 (60%) had no reported observations; 130 patients had 166 reported observations: 114 (68.7%) LR-1, 8 (4.8%) LR-2, 21 (12.6%) LR-3, 6 (3.6%) LR-4, 13 (7.8%) LR-5, 3 (1.8%) LR-M, and 1 (0.6%) LR-TIV. Of 114 LR-1 observations, 78 (68%) were cysts, 17 (15%) were hemangiomas, 12 (11%) were vascular shunts, 3 (3%) were focal nodular hyperplasia, 2 (2%) were siderotic nodules, 1 (1%) was a lipoma, and 1 (1%) was biliary hamartoma. There were 23 observations with probably or definitely malignant categories (LR-4, LR-5, LR-M or LR- TIV), reported in 20/329 (6%) of patients.
Conclusion: In a cohort of at-risk patients undergoing contrast-enhanced CT/MRI for HCC screening, 60% of had no liver observations, and 6 % had probably or definitely malignant observations.
Implications For Patient Care: The prevalence of LI-RADS v2018 categories on CT or MR exams used for HCC screening can help develop screening criteria and assess cost-effectiveness of surveillance strategies with CT and MRI.
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Article Synopsis
- The study aims to evaluate how well LI-RADS (Liver Imaging Reporting and Data System) diagnoses liver cancer in patients with non-cirrhotic HCV infection, analyzing data from 66 observations involving adult patients.
- Results show that while LI-RADS categories like LR-1 and LR-2 had no predictive value, LR-5 demonstrated high sensitivity (74-90%) and specificity (94-100%) for hepatic cellular carcinoma (HCC), making it a reliable indicator.
- The inter-reader agreement among radiologists was substantial for final assessments, suggesting that LI-RADS can be effectively used for diagnosing malignancies in this patient group with excellent specificity.
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