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Erschienen in: Abdominal Radiology 9/2016

04.05.2016

Natural history of liver imaging reporting and data system category 4 nodules in MRI

verfasst von: Lauren M. B. Burke, Keitaro Sofue, Madavi Alagiyawanna, Viragi Nilmini, Andrew J. Muir, Kingshuk R. Choudhury, Richard C. Semelka, Mustafa R. Bashir

Erschienen in: Abdominal Radiology | Ausgabe 9/2016

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Abstract

Purpose: The purpose of this study was to characterize the MR imaging features and outcomes of liver imaging reporting and data system (LI-RADS) category 4 (LR4) nodules, with an emphasis on upgrade to category 5 (LR5) and development of contraindications to curative therapy. Methods: Institutional review board approval was obtained for this retrospective, dual-institutional Health Insurance Portability and Accountability Act-compliant study. The requirement for informed consent was waived. Contrast-enhanced MRI studies performed on patients with cirrhosis were retrospectively assessed using LI-RADS 2014 by at least two readers. All nodules were individually evaluated to determine their major imaging features at diagnosis, and follow-up data were used to determine the associated imaging outcomes. Results: One hundred eighty-one untreated LR4 nodules in 139 patients had adequate imaging and follow-up for inclusion in the study. Most (61% [111/181]) of these demonstrated arterial phase hyperenhancement, washout, and diameter less than 20 mm. During the follow-up period (median 163 days), 31% (56/181) of the nodules upgraded to LR5, 40% (73/181) remained stable, and 29% (52/181) downgraded. Of the nodules that upgraded, 61% (34/56) increased their size category and 54% (30/56) developed newly visualized capsules. No LR4 nodules developed venous invasion, satellites nodules, or new intrahepatic or extrahepatic metastatic disease. 75% (42/56) of the nodules that upgraded to LR5 did so within 6 months. Conclusions: Approximately one-third of LR4 nodules upgrade to LR5, and the short-term risk of developing venous invasion or metastasis is very low.
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Metadaten
Titel
Natural history of liver imaging reporting and data system category 4 nodules in MRI
verfasst von
Lauren M. B. Burke
Keitaro Sofue
Madavi Alagiyawanna
Viragi Nilmini
Andrew J. Muir
Kingshuk R. Choudhury
Richard C. Semelka
Mustafa R. Bashir
Publikationsdatum
04.05.2016
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 9/2016
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-016-0762-3

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