Assessment of primary liver carcinomas other than hepatocellular carcinoma (HCC) with LI-RADS v2018: comparison of the LI-RADS target population to patients without LI-RADS-defined HCC risk factors.

Objectives: To determine whether the LI-RADS imaging features of primary liver carcinomas (PLCs) other than hepatocellular carcinoma (non-HCC PLCs) differ between patients considered high risk (RF+) versus not high risk (RF-) for HCC and to compare rates of miscategorization as probable or definite...

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Published in:European Radiology Vol. 30; no. 2; pp. 996 - 1008
Main Authors: Fraum, Tyler J., Cannella, Roberto, Ludwig, Daniel R., Tsai, Richard, Naeem, Muhammad, LeBlanc, Maverick, Salter, Amber, Tsung, Allan, Shetty, Anup S., Borhani, Amir A., Furlan, Alessandro, Fowler, Kathryn J.
Format: research Journal Article
Published: Springer Nature Feb2020
Online Access:View this record in EBSCOhost
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      dt: Feb2020
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      pub: Springer Nature
      place: New York, New York
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        atl: Assessment of primary liver carcinomas other than hepatocellular carcinoma (HCC) with LI-RADS v2018: comparison of the LI-RADS target population to patients without LI-RADS-defined HCC risk factors.
      aug:
        au:
          Fraum, Tyler J.
          Cannella, Roberto
          Ludwig, Daniel R.
          Tsai, Richard
          Naeem, Muhammad
          LeBlanc, Maverick
          Salter, Amber
          Tsung, Allan
          Shetty, Anup S.
          Borhani, Amir A.
          Furlan, Alessandro
          Fowler, Kathryn J.
        affil: Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 S. Kingshighway Blvd, 63110, Saint Louis, MO, USA
      sug:
        subj:
          Carcinoma, Hepatocellular
          Liver Neoplasms
          Middle Age
          Magnetic Resonance Imaging Methods
          Logistic Regression
          Single-Blind Studies
          Contrast Media
          Human
          Female
          Tomography, X-Ray Computed Methods
          Retrospective Design
          Risk Factors
          Male
          Liver Neoplasms Pathology
          Carcinoma, Hepatocellular Pathology
          Diagnosis, Differential
          Aged
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Psychological Tests
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Objectives: To determine whether the LI-RADS imaging features of primary liver carcinomas (PLCs) other than hepatocellular carcinoma (non-HCC PLCs) differ between patients considered high risk (RF+) versus not high risk (RF-) for HCC and to compare rates of miscategorization as probable or definite HCC between the RF+ and RF- populations.Methods: This retrospective study included all pathology-proven non-HCC PLCs imaged with liver-protocol CT or MRI from 2007 to 2017 at two liver transplant centers. Patients were defined per LI-RADS v2018 criteria as RF+ or RF-. Two independent, blinded readers (R1, R2) categorized 265 lesions using LI-RADS v2018. Logistic regression was utilized to assess for differences in imaging feature frequencies between RF+ and RF- patients. Fisher's exact test was used to assess for differences in miscategorization rates.Results: Non-HCC PLCs were significantly more likely to exhibit nonrim arterial phase hyperenhancement (R1: OR = 2.94; R2: OR = 7.09) and nonperipheral "washout" (R1: OR = 3.65; R2: OR = 7.69) but significantly less likely to exhibit peripheral "washout" (R1: OR = 0.30; R2: OR = 0.10) and delayed central enhancement (R1: OR = 0.18; R2: OR = 0.25) in RF+ patients relative to RF- patients. Consequently, non-HCC PLCs were more often miscategorized as probable or definite HCC in RF+ versus RF- patients (R1: 23.3% vs. 3.6%, p < 0.001; R2: 11.0% vs. 2.6%, p = 0.009).Conclusions: Non-HCC PLCs are more likely to mimic HCCs on CT and MRI in the LI-RADS target population than in patients without LI-RADS-defined HCC risk factors.Key Points: • The presence of LI-RADS-defined risk factors for HCC tends to alter the imaging appearances of non-HCC PLCs, resulting in higher frequencies of major features and lower frequencies of LR-M features. • Non-HCC PLCs are more likely to be miscategorized as probable or definite HCC in the LI-RADS target population than in patients without LI-RADS-defined HCC risk factors.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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