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Locoregional therapies for hepatocellular carcinoma and the new LI-RADS treatment response algorithm

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Abstract

Radiologists play a central role in the assessment of patient response to locoregional therapies for hepatocellular carcinoma (HCC). The identification of viable tumor following treatment guides further management and potentially affects transplantation eligibility. Liver Imaging Reporting and Data Systems (LI-RADS) first introduced the concept of LR-treated in 2014, and a new treatment response algorithm is included in the 2017 update to assist radiologists in image interpretation of HCC after locoregional therapy. In addition to offering imaging criteria for viable and nonviable HCC, new concepts of nonevaluable tumors as well as tumors with equivocal viability are introduced. Existing guidelines provided by response evaluation criteria in solid tumors (RECIST) and modified RECIST address patient-level assessments and are routinely used in clinical trials but do not address the variable appearances following different locoregional therapies. The new LI-RADS treatment response algorithm addresses this gap and offers a comprehensive approach to assess treatment response for individual lesions after a variety of locoregional therapies, using either contrast-enhanced CT or MRI.

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Acknowledgment

We thank Joanne Chin for editorial assistance.

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Authors and Affiliations

  1. Department of Radiology, University of Ottawa, Ottawa, Canada

    Ania Kielar

  2. Department of Radiology, Washington University, St. Louis, MO, USA

    Kathryn J. Fowler

  3. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Sara Lewis

  4. Department of Radiology, Northwestern Memorial Hospital, Northwestern University–Feinberg School of Medicine, Chicago, IL, USA

    Vahid Yaghmai & Frank H. Miller

  5. Department of Radiology, Duke University, Durham, NC, USA

    Charles Kim

  6. Department of Radiology, Montefiore Medical Center, New York, NY, USA

    Victoria Chernyak

  7. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Takeshi Yokoo

  8. Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Jeffrey Meyer

  9. Department of Radiology, UC San Diego, San Diego, CA, USA

    Isabel Newton

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

    Hooman Yarmohammadi & Richard K. Do

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  1. Ania Kielar
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Corresponding author

Correspondence to Richard K. Do.

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Funding

Ania Kielar was funded by General Electric. Richard K Do received support from the NIH/NCI Cancer Center Support Grant P30 CA008748.

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The authors declare that they have no conflict of interest.

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Kielar, A., Fowler, K.J., Lewis, S. et al. Locoregional therapies for hepatocellular carcinoma and the new LI-RADS treatment response algorithm. Abdom Radiol 43, 218–230 (2018). https://doi.org/10.1007/s00261-017-1281-6

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  • DOI: https://doi.org/10.1007/s00261-017-1281-6

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