Effect of threshold growth as a major feature on LI-RADS categorization

被引:17
作者
Chernyak, Victoria [1 ]
Kobi, Mariya [1 ]
Flusberg, Milana [1 ]
Fruitman, Kate C. [1 ]
Sirlin, Claude B. [2 ]
机构
[1] Montefiore Med Ctr, Dept Radiol, 111 E 210th St, Bronx, NY 10467 USA
[2] Univ Calif San Diego, Dept Radiol, Liver Imaging Grp, La Jolla, CA 92093 USA
关键词
LI-RADS; Threshold growth; Hepatocellular carcinoma; Major feature; Ancillary feature; ENHANCED MR-IMAGES; NODULES; 20; MM; HEPATOCELLULAR-CARCINOMA; DATA SYSTEM; PRACTICE GUIDELINES; HEPATIC NODULES; LIVER; DIAGNOSIS; CIRRHOSIS; MANAGEMENT;
D O I
10.1007/s00261-017-1105-8
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: Liver Imaging Reporting and Data System (LI-RADS) uses major features (arterial phase hyperenhancement [APHE], ''washout'' [WO], ''capsule,'' diameter, threshold growth [TG]) to codify probability of hepatocellular carcinoma for each observation. This study assessed the effect of removing TG as a major feature on LI-RADS categorization. Materials and methods: In this HIPAA-compliant, IRB-approved study, all MR and CT clinical reports containing a standardized LI-RADS v2014 template between 4/15-1/17 were retrospectively reviewed for each LR-3, LR-4, and LR-5 reported observation. Two LI-RADS categories were then assigned: one using all LI-RADS major features and one after removing TG as a major feature. The two categories were compared descriptively. Results: The study included 265 patients (172 [65%] male, mean age 63 [+/- 10] years) with 489 observations (median diameter 14 mm, IQR 10-20 mm), of which 345 (71%) had APHE, 307 (63%) had WO, 86 (18%) had ''capsule,'' and 72 (15%) had TG. Of 86 observations with TG, 47 (65%) were new observations >= 10 mm, 14 (19%) had diameter increase >= 50% in <= 6 months, and 11 (15%) had diameter increase >= 100% in >6 months. Using all major features, 214/489 (44%) observations were LR-3, 129/489 (26%) were LR-4, and 146/489 (30%) were LR-5. After removing TG, 237/489 (48%) were LR-3, 119/489 (24%) were LR-4, and 133 (27%) were LR-5. Removing TG caused a category downgrade for 35/489 (7%, 95% CI 5-10) observations, including 13/146 (9%, 95% CI 3-14) LR-5 observations. Conclusion: 9% of LR-5 observations would be downgraded without TG.
引用
收藏
页码:2089 / 2100
页数:12
相关论文
共 38 条
[1]  
[Anonymous], 2014, LIV IM REP DAT SYST
[2]   Concordance of hypervascular liver nodule characterization between the organ procurement and transplant network and liver imaging reporting and data system classifications [J].
Bashir, Mustafa R. ;
Huang, Rong ;
Mayes, Nicholas ;
Marin, Daniele ;
Berg, Carl L. ;
Nelson, Rendon C. ;
Jaffe, Tracy A. .
JOURNAL OF MAGNETIC RESONANCE IMAGING, 2015, 42 (02) :305-314
[3]   Characterization of small nodules in cirrhosis by assessment of vascularity: The problem of hypovascular hepatocellular carcinoma [J].
Bolondi, L ;
Gaiani, S ;
Celli, N ;
Goffieri, R ;
Grigioni, WF ;
Leoni, S ;
Venturi, AM ;
Piscaglia, F .
HEPATOLOGY, 2005, 42 (01) :27-34
[4]   Management of hepatoceullular carcinoma [J].
Bruix, J ;
Sherman, M .
HEPATOLOGY, 2005, 42 (05) :1208-1236
[5]   Management of Hepatocellular Carcinoma: An Update [J].
Bruix, Jordi ;
Sherman, Morris .
HEPATOLOGY, 2011, 53 (03) :1020-1022
[6]   Natural history of liver imaging reporting and data system category 4 nodules in MRI [J].
Burke, Lauren M. B. ;
Sofue, Keitaro ;
Alagiyawanna, Madavi ;
Nilmini, Viragi ;
Muir, Andrew J. ;
Choudhury, Kingshuk R. ;
Semelka, Richard C. ;
Bashir, Mustafa R. .
ABDOMINAL RADIOLOGY, 2016, 41 (09) :1758-1766
[7]   Hepatocellular Carcinoma: Imaging Patterns on Gadoxetic Acid-enhanced MR Images and Their Value as an Imaging Biomarker [J].
Choi, Jin Woo ;
Lee, Jeong Min ;
Kim, Soo Jin ;
Yoon, Jeong-Hee ;
Baek, Jee Hyun ;
Han, Joon Koo ;
Choi, Byung Ihn .
RADIOLOGY, 2013, 267 (03) :776-786
[8]   Liver Imaging Reporting and Data System v2014 With Gadoxetate Disodium-Enhanced Magnetic Resonance Imaging Validation of LI-RADS Category 4 and 5 Criteria [J].
Choi, Sang Hyun ;
Byun, Jae Ho ;
Kim, So Yeon ;
Lee, So Jung ;
Won, Hyung Jin ;
Shin, Yong Moon ;
Kim, Pyo Nyun .
INVESTIGATIVE RADIOLOGY, 2016, 51 (08) :483-490
[9]   Differences in Liver Imaging and Reporting Data System Categorization Between MRI and CT [J].
Corwin, Michael T. ;
Fananapazir, Ghaneh ;
Jin, Michael ;
Lamba, Ramit ;
Bashir, Mustafa R. .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2016, 206 (02) :307-312
[10]   Liver Imaging Reporting and Data System with MR Imaging: Evaluation in Nodules 20 mm or Smaller Detected in Cirrhosis at Screening US [J].
Darnell, Anna ;
Forner, Alejandro ;
Rimola, Jordi ;
Reig, Maria ;
Garcia-Criado, Angeles ;
Ayuso, Carmen ;
Bruix, Jordi .
RADIOLOGY, 2015, 275 (03) :698-707