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Erschienen in: Abdominal Radiology 5/2016

02.01.2016

Rate of observation and inter-observer agreement for LI-RADS major features at CT and MRI in 184 pathology proven hepatocellular carcinomas

verfasst von: Eric C. Ehman, Spencer C. Behr, Sarah E. Umetsu, Nicholas Fidelman, Ben M. Yeh, Linda D. Ferrell, Thomas A. Hope

Erschienen in: Abdominal Radiology | Ausgabe 5/2016

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Abstract

Purpose

To compare frequency and inter-reader agreement for LI-RADS v2014 major features at CT vs. MRI in pathology-proven cases of hepatocellular carcinoma.

Methods

Pathology reports and imaging studies from patients having undergone liver transplant or hepatectomy for hepatocellular carcinoma were reviewed. Size, location, washout, and capsule appearance for each lesion were recorded by two radiologists. Cohen’s kappa and intraclass correlation coefficients (ICC) were calculated.

Results

One hundred and thirty-four patients with 184 tumors were reviewed. Seventy-seven percentage of lesions were imaged by CT and 23% by MRI. No lesions were evaluated with both modalities. Mean lesion diameter was 2.6 ± 1.3 cm (ICC = 0.92). Arterial phase hyperenhancement was seen in 86% of lesions (κ = 0.75). Washout was seen in 82% of studies (κ = 0.61). Arterial phase hyperenhancement and washout were seen equally at CT and MRI (p = 1.00 and 0.46, respectively). Capsule was infrequently observed (27%) but was seen more commonly at MRI (44%) than at CT (17%) with p = 0.002 and (κ = 0.56). Forty-seven percent of lesions with at least one prior study met LI-RADS criteria for threshold growth. The rates of LI-RADS categories 3, 4, and 5 were 9%, 37%, and 54%, respectively. More 1–2 cm LI-RADS 5 lesions were seen at MRI (43%) than at CT (8%), p = 0.01.

Conclusion

A combined LI-RADS 4/5 group was 91% sensitive for hepatocellular carcinoma. Arterial enhancement and washout were seen more frequently than capsule, the sole finding seen more frequently at MRI than at CT. Inter-reader reliability was substantial for arterial hyperenhancement and washout but moderate for capsule. Capsule remains an important finding in small arterially enhancing lesions (1–2 cm) which require a second major criterion to upgrade to a LI-RADS 5 lesion.
Literatur
2.
Zurück zum Zitat Wald C, Russo MW, Heimbach JK, et al. (2013) New OPTN/UNOS policy for liver transplant allocation: standardization of liver imaging, diagnosis, classification, and reporting of hepatocellular carcinoma. Radiology 266(2):376–382. doi:10.1148/radiol.12121698 CrossRefPubMed Wald C, Russo MW, Heimbach JK, et al. (2013) New OPTN/UNOS policy for liver transplant allocation: standardization of liver imaging, diagnosis, classification, and reporting of hepatocellular carcinoma. Radiology 266(2):376–382. doi:10.​1148/​radiol.​12121698 CrossRefPubMed
6.
Zurück zum Zitat Kudo M, Izumi N, Kokudo N, et al. (2011) Management of hepatocellular carcinoma in Japan: Consensus-Based Clinical Practice Guidelines proposed by the Japan Society of Hepatology (JSH) 2010 updated version. Digest Dis 29(3):339–364. doi:10.1159/000327577 CrossRef Kudo M, Izumi N, Kokudo N, et al. (2011) Management of hepatocellular carcinoma in Japan: Consensus-Based Clinical Practice Guidelines proposed by the Japan Society of Hepatology (JSH) 2010 updated version. Digest Dis 29(3):339–364. doi:10.​1159/​000327577 CrossRef
9.
Zurück zum Zitat Freeman RB Jr, Gish RG, Harper A, et al. (2006) Model for end-stage liver disease (MELD) exception guidelines: results and recommendations from the MELD Exception Study Group and Conference (MESSAGE) for the approval of patients who need liver transplantation with diseases not considered by the standard MELD formula. Liver Transplant 12(12 Suppl 3):S128–S136. doi:10.1002/lt.20979 CrossRef Freeman RB Jr, Gish RG, Harper A, et al. (2006) Model for end-stage liver disease (MELD) exception guidelines: results and recommendations from the MELD Exception Study Group and Conference (MESSAGE) for the approval of patients who need liver transplantation with diseases not considered by the standard MELD formula. Liver Transplant 12(12 Suppl 3):S128–S136. doi:10.​1002/​lt.​20979 CrossRef
10.
Zurück zum Zitat Sharma P, Balan V, Hernandez JL, et al. (2004) Liver transplantation for hepatocellular carcinoma: the MELD impact. Liver Transplant 10(1):36–41. doi:10.1002/lt.20012 CrossRef Sharma P, Balan V, Hernandez JL, et al. (2004) Liver transplantation for hepatocellular carcinoma: the MELD impact. Liver Transplant 10(1):36–41. doi:10.​1002/​lt.​20012 CrossRef
12.
13.
Zurück zum Zitat Rode A, Bancel B, Douek P, et al. (2001) Small nodule detection in cirrhotic livers: evaluation with US, spiral CT, and MRI and correlation with pathologic examination of explanted liver. J Comput Assist Tomogr 25(3):327–336CrossRefPubMed Rode A, Bancel B, Douek P, et al. (2001) Small nodule detection in cirrhotic livers: evaluation with US, spiral CT, and MRI and correlation with pathologic examination of explanted liver. J Comput Assist Tomogr 25(3):327–336CrossRefPubMed
16.
Zurück zum Zitat Sangiovanni A, Manini MA, Iavarone M, et al. (2010) The diagnostic and economic impact of contrast imaging techniques in the diagnosis of small hepatocellular carcinoma in cirrhosis. Gut 59(5):638–644. doi:10.1136/gut.2009.187286 CrossRefPubMed Sangiovanni A, Manini MA, Iavarone M, et al. (2010) The diagnostic and economic impact of contrast imaging techniques in the diagnosis of small hepatocellular carcinoma in cirrhosis. Gut 59(5):638–644. doi:10.​1136/​gut.​2009.​187286 CrossRefPubMed
17.
18.
Zurück zum Zitat Fowler KJ, Karimova EJ, Arauz AR, et al. (2013) Validation of organ procurement and transplant network (OPTN)/united network for organ sharing (UNOS) criteria for imaging diagnosis of hepatocellular carcinoma. Transplantation 95(12):1506–1511. doi:10.1097/TP.0b013e31828eeab2 CrossRefPubMed Fowler KJ, Karimova EJ, Arauz AR, et al. (2013) Validation of organ procurement and transplant network (OPTN)/united network for organ sharing (UNOS) criteria for imaging diagnosis of hepatocellular carcinoma. Transplantation 95(12):1506–1511. doi:10.​1097/​TP.​0b013e31828eeab2​ CrossRefPubMed
22.
Zurück zum Zitat Cereser L, Furlan A, Bagatto D, et al. (2010) Comparison of portal venous and delayed phases of gadolinium-enhanced magnetic resonance imaging study of cirrhotic liver for the detection of contrast washout of hypervascular hepatocellular carcinoma. J Comput Assist Tomogr 34(5):706–711. doi:10.1097/RCT.0b013e3181e1a88e CrossRefPubMed Cereser L, Furlan A, Bagatto D, et al. (2010) Comparison of portal venous and delayed phases of gadolinium-enhanced magnetic resonance imaging study of cirrhotic liver for the detection of contrast washout of hypervascular hepatocellular carcinoma. J Comput Assist Tomogr 34(5):706–711. doi:10.​1097/​RCT.​0b013e3181e1a88e​ CrossRefPubMed
24.
25.
Zurück zum Zitat Edge SBD, Compton CC, Fritz AG, Greene FL, Trotti A (2010) AJCC cancer staging handbook, 7th edn. Chicago: American Joint Committee on Cancer Edge SBD, Compton CC, Fritz AG, Greene FL, Trotti A (2010) AJCC cancer staging handbook, 7th edn. Chicago: American Joint Committee on Cancer
Metadaten
Titel
Rate of observation and inter-observer agreement for LI-RADS major features at CT and MRI in 184 pathology proven hepatocellular carcinomas
verfasst von
Eric C. Ehman
Spencer C. Behr
Sarah E. Umetsu
Nicholas Fidelman
Ben M. Yeh
Linda D. Ferrell
Thomas A. Hope
Publikationsdatum
02.01.2016
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 5/2016
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-015-0623-5

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