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Prevalence of different LI-RADS v2018 categories in high-risk patients undergoing CT- or MRI-based screening for hepatocellular carcinoma

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope

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.

Graphical abstract

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Abbreviations

AASLD:

American Association for the Study of Liver Diseases

APHE:

Arterial phase hyperenhancement

CT:

Computed tomography

HCC:

Hepatocellular carcinoma

LI-RADS:

Liver imaging reporting and data system

LR:

Liver imaging reporting and data system

MF:

Major feature

MRI:

Magnetic resonance imaging

TG:

Threshold growth

v2018:

Version 2018

WO:

Washout appearance

iCCA:

Intrahepatic cholangiocarcinoma

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Haneyeh Shahbazian & Ihab Kamel

  2. Department of Radiology, Montefiore Medical Center, Bronx, NY, USA

    Jason Birnbaum, Devaraju Kanmaniraja & Victoria Chernyak

  3. Department of Radiology, Mount Sinai Hospital, New York, NY, USA

    Jason Birnbaum

  4. Liver Imaging Group, University of California San Diego, San Diego, CA, USA

    Patricia J. Burns, Sedighe Hosseini Shabanan & Claude B. Sirlin

  5. Department of Hepatology, Montefiore Medical Center, Bronx, NY, USA

    John Reinus

  6. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Victoria Chernyak

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  1. Haneyeh Shahbazian
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Corresponding author

Correspondence to Victoria Chernyak.

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Conflict of interest

V. Chernyak: Consultant, Bayer. CB Sirlin: Dr. Sirlin reports research grants from ACR, Bayer, Foundation of NIH, GE, Gilead, Pfizer, Philips, Siemens; lab service agreements with Enanta, Gilead, ICON, Intercept, Nusirt, Shire, Synageva, Takeda; institutional consulting for BMS, Exact Sciences, IBM-Watson, Pfizer; Personal consulting for Altimmune, Ascelia Pharma, Blade, Boehringer, Epigenomics; and Guerbet; receipt of royalties and/or honoraria from Medscape and Wolters Kluwer; ownership of stock options in Livivos; unpaid advisory board position in Quantix Bio. Dr. Sirlin serves as Chief Medical Officer for Livivos (unsalaried position with stock options), an appointment approved by his university.

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Shahbazian, H., Birnbaum, J., Burns, P.J. et al. Prevalence of different LI-RADS v2018 categories in high-risk patients undergoing CT- or MRI-based screening for hepatocellular carcinoma. Abdom Radiol 48, 3696–3702 (2023). https://doi.org/10.1007/s00261-023-04040-7

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  • DOI: https://doi.org/10.1007/s00261-023-04040-7

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