LI-RADS 4 or 5 categorization may not be clinically relevant for decision-making processes: A prospective cohort
Federico Piñero1, Marcos A Thompson2, Federico Diaz Telli3
1Hepatology and Liver Unit, Hospital Universitario Austral, School of Medicine, Austral University, Buenos Aires, Argentina; Latin American Liver Research Educational and Awareness Network (LALREAN), Buenos Aires, Argentina.
Annals of Hepatology
|July 20, 2020
Summary
The Liver Imaging Reporting and Data System (LI-RADS) aids in standardizing hepatocellular carcinoma (HCC) reporting. However, this study found no significant difference in HCC probability between LI-RADS LR-4 and LR-5 categories when compared to explant pathology.
Area of Science:
- Hepatobiliary imaging
- Oncology
- Transplant surgery
Background:
- The Liver Imaging Reporting and Data System (LI-RADS) was developed to standardize hepatocellular carcinoma (HCC) reporting.
- Its clinical utility in Latin America, particularly in comparison to histopathology, requires evaluation.
Purpose of the Study:
- To compare LI-RADS categories with histopathology findings in liver transplant (LT) explants.
- To assess the clinical utility of LI-RADS in a regional Latin American center.
Main Methods:
- A prospective cohort study was conducted from 2012 to 2018 in Argentina.
- LI-RADS definitions were applied to MRI or CT scans of HCC patients listed for LT, comparing them to explant pathology.
- The study focused on major nodules (NOD1) in 72 patients who underwent LT.
Main Results:
- Among 42 LT patients with pre-transplant imaging, 69% of major nodules were categorized as LI-RADS LR-5, 21% as LR-4, and 10% as LR-3.
- HCC was confirmed in 50% of LR-3, 89% of LR-4, and 77% of LR-5 nodules.
- Microvascular invasion was noted in 11% of LR-4 and 17% of LR-5 nodules.
Conclusions:
- LI-RADS proved useful for standardizing HCC reporting in this cohort.
- No significant differences in HCC probability were observed between LI-RADS LR-4 and LR-5 categories when correlated with explant pathology.
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