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Journal articles on the topic 'LI-RADS'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Renzulli, Matteo, Alfredo Clemente, Stefano Brocchi, Matteo Milandri, Vincenzo Lucidi, Ranka Vukotic, Salvatore Cappabianca, and Rita Golfieri. "LI-RADS." European Journal of Gastroenterology & Hepatology 31, no. 3 (March 2019): 283–88. http://dx.doi.org/10.1097/meg.0000000000001269.

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2

Santillan, Cynthia S., An Tang, Irene Cruite, Amol Shah, and Claude B. Sirlin. "Understanding LI-RADS." Magnetic Resonance Imaging Clinics of North America 22, no. 3 (August 2014): 337–52. http://dx.doi.org/10.1016/j.mric.2014.04.007.

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3

Rodgers, Shuchi K., David T. Fetzer, Helena Gabriel, James H. Seow, Hailey H. Choi, Katherine E. Maturen, Ashish P. Wasnik, et al. "Role of US LI-RADS in the LI-RADS Algorithm." RadioGraphics 39, no. 3 (May 2019): 690–708. http://dx.doi.org/10.1148/rg.2019180158.

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4

Liu, Weimin, Jie Qin, Ruomi Guo, Sidong Xie, Hang Jiang, Xiaohong Wang, Zhuang Kang, Jin Wang, and Hong Shan. "Accuracy of the diagnostic evaluation of hepatocellular carcinoma with LI-RADS." Acta Radiologica 59, no. 2 (June 26, 2017): 140–46. http://dx.doi.org/10.1177/0284185117716700.

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Background There are few studies about the Liver Imaging Reporting and Data System (LI-RADS), which was developed with the purpose of standardizing the interpretation and reporting of liver imaging examinations in patients at risk for hepatocellular carcinoma (HCC). Purpose To evaluate the diagnostic accuracy of HCC diagnosis using LI-RADS. Material and Methods The computed tomography (CT), magnetic resonance imaging (MRI), and clinical data of 297 lesions in 249 patients between June 2012 and August 2013 were retrospectively analyzed. Using LI-RADS 2014, two radiologists evaluated the lesions and a LI-RADS category was retrospectively assigned to each nodule. Results The final diagnoses of 297 nodules in 249 patients consisted of 191 malignant and 106 benign lesions. Out of 44 LI-RADS category 1 lesions, none were HCCs. However, 2/25 category 2 lesions, 3/35 category 3 lesions, 16/25 category 4 lesions, 151/156 category 5 lesions, and 3/12 category LRM/OM (probable malignancy, not specific for HCC/other malignancy) lesions were HCCs. The Kappa value was 0.44 (95% confidence interval [CI] = 0.39–0.49) between two observers during LI-RADS grading. Conclusion The negative predictive value of LI-RADS category 1 was 100%. In addition, a relevant proportion of lesions categorized as category 2 or 3, or even as other malignancies, were HCCs. LI-RADS category 5 had a high specificity for HCC. LI-RADS was not able to give a differential diagnosis for the false-positive lesions of LI-RADS category 5.

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Garcia Belen, Mendoza, and Contreras Vazquez Constantino. "ASOCIACION DE LA CLASIFICACION LI-RADS 2018 CON LOS HALLAZGOS HISTOPATOLOGICOS DE CARCINOMA HEPATOCELULAR, EN EL CENTRO MEDICO NAVAL, PERIODO: ENERO 2016 - DICIEMBRE 2020." International Journal of Advanced Research 9, no. 07 (July 31, 2021): 612–23. http://dx.doi.org/10.21474/ijar01/13163.

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The LI-RADS Classification is an interpretation and reporting system to classify focal alterations of the liver with the risk of developing Hepatocellular Carcinoma, using a series of major criteria in Computed Tomography and Magnetic Resonance These findings can be classified into 5 categories.The objective of this thesis is to identify if there is an association between the LI-RADS 2018 classification and the histopathological results of patients with Hepatocellular Carcinoma from the Naval Medical Center. Materials And Methods:An observational, descriptive, cross-sectional, retrospective study was carried out from January 2016 to December 2020. In this study, 35 patients with a diagnosis of Hepatocellular Carcinoma were analyzed, who underwent Computed Tomography or Abdomino-pelvic Magnetic Resonance , to associate said pathology with imaging findings, complying with the most characteristic major criteria that allow staging in the LI-RADS 2018 System. Results:Of the 35 patients, 57% were women (n = 20), 43% were men (n = 15). Of the total number of patients, 80% were Beneficiaries and the method of obtaining the sample for all patients was closed biopsy with a percutaneous needle. The distribution of the 2018 LI-RADS scale in all patients with liver biopsy was: LI-RADS 1 n = 8 (22.8%), LI-RADS 2 n = 5 (14.2%), LI-RADS 3 n = 12 (34.2%), LI-RADS 4 n = 3 (8.5%), LI-RADS 5 n = 7 (20%). It was found that the LI-RADS 5 category obtained a value of p = 0.001, with a specificity of 100%, a sensitivity of 70%, a PPV of 100% and a NPV of 89%, with an incidence of 20%. Conclusions:This study shows, through the results obtained, that there is a positive association between the LI-RADS 2018 classification of the ACR and the histopathological findings of Hepatocellular Carcinoma.

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6

Centonze, Leonardo, Riccardo De Carlis, Ivan Vella, Luca Carbonaro, Niccolò Incarbone, Livia Palmieri, Cristiano Sgrazzutti, et al. "From LI-RADS Classification to HCC Pathology: A Retrospective Single-Institution Analysis of Clinico-Pathological Features Affecting Oncological Outcomes after Curative Surgery." Diagnostics 12, no. 1 (January 10, 2022): 160. http://dx.doi.org/10.3390/diagnostics12010160.

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Background: The latest Liver Imaging Reporting and Data System (LI-RADS) classification by the American College of Radiology has been recently endorsed in the American Association for the Study of Liver Disease (AASLD) guidelines for Hepatocellular carcinoma (HCC) management. Although the LI-RADS protocol has been developed as a diagnostic algorithm, there is some evidence concerning a possible correlation between different LI-RADS classes and specific pathological features of HCC. We aimed to investigate such radiological/pathological correlation and the possible prognostic implication of LI-RADS on a retrospective cohort of HCC patients undergoing surgical resection. Methods: We performed a retrospective analysis of the pathological characteristics of resected HCC, exploring their distribution among different LI-RADS classes and analyzing the risk factors for recurrence-free, overall and cancer-specific survival Results: LI-RADS-5 (LR-5) nodules showed a higher prevalence of microvascular invasion (MVI), satellitosis and capsule infiltration, as well as higher median values of alpha-fetoprotein (αFP) compared to LI-RADS-3/4 (LR-3/4) nodules. MVI, αFP, satellitosis and margin-positive (R1) resection resulted as independent risk factors for recurrence-free survival, while LI-RADS class did not exert any significant impact. Focusing on overall survival, we identified patient age, Eastern Cooperative Oncology Group performance status (ECOG-PS), Model for End Stage Liver Disease (MELD) score, αFP, MVI, satellitosis and R1 resection as independent risk factors for survival, without any impact of LI-RADS classification. Last, MELD score, log10αFP, satellitosis and R1 resection resulted as independent risk factors for cancer-specific survival, while LI-RADS class did not exert any significant impact. Conclusions: Our results suggest an association of LR-5 class with unfavorable pathological characteristics of resected HCC; tumor histology and underlying patient characteristics such as age, ECOG-PS and liver disease severity exert a significant impact on postoperative oncological outcomes.

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7

Chernyak, Victoria, and Claude B. Sirlin. "LI‐RADS: Future Directions." Clinical Liver Disease 17, no. 3 (March 2021): 149–53. http://dx.doi.org/10.1002/cld.1034.

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8

Narsinh, Kazim H., Jennifer Cui, Demetri Papadatos, Claude B. Sirlin, and Cynthia S. Santillan. "Hepatocarcinogenesis and LI-RADS." Abdominal Radiology 43, no. 1 (December 5, 2017): 158–68. http://dx.doi.org/10.1007/s00261-017-1409-8.

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Papadatos, Demetrios, Kathryn J. Fowler, Ania Z. Kielar, Jennifer Cui, and Claude B. Sirlin. "Cirrhosis and LI-RADS." Abdominal Radiology 43, no. 1 (December 7, 2017): 26–40. http://dx.doi.org/10.1007/s00261-017-1425-8.

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10

An, Julie Y., Kyle M. L. Unsdorfer, and Jeffrey C. Weinreb. "BI-RADS, C-RADS, CAD-RADS, LI-RADS, Lung-RADS, NI-RADS, O-RADS, PI-RADS, TI-RADS: Reporting and Data Systems." RadioGraphics 39, no. 5 (September 2019): 1435–36. http://dx.doi.org/10.1148/rg.2019190087.

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11

Potthoff, Andrej, Thomas Helmberger, Andre Ignee, Juergen K. Willmann, and Christoph F. Dietrich. "Standardisierte Befundung und Dokumentation der Kontrastmittelsonografie der Leber (CEUS LI-RADS)." Zeitschrift für Gastroenterologie 56, no. 05 (May 2018): 499–506. http://dx.doi.org/10.1055/s-0043-124874.

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ZusammenfassungIn der Abklärung von hepatozellulären Karzinomen (HCCs) bei Hochrisikopatienten wurde zur standardisierten Befundung und Dokumentation der Kontrastmittel-Computertomografie (CECT) und Kontrastmittel-Magnetresonanztomografie (CEMRT) vor wenigen Jahren das „Liver Imaging Reporting and Data System” (LI-RADS) durch das American College of Radiology (ACR) erstellt. Die LI-RADS-Kategorisierung wird zur Klassifikation von Leberläsionen in der Leberzirrhose als sicher benigne (LR-1), intermediär (LR2 – 4) bis zu „definitiv HCC“ (LR-5) beurteilt. Seit 2014 wurde die LI-RADS-Klassifikation durch eine Arbeitsgruppe von internationalen Radiologen und Hepatologen auf die Kontrastmittelsonografie erweitert. Zeitgleich mit der Zulassung des Kontrastmittels SonoVue™ (in den USA Lumason™) wurde die Klassifikation 2016 in die LI-RADS Kategorisierung integriert und wird in diesem Artikel erläutert (CEUS-LI-RADS).

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Centonze, Leonardo, Stefano Di Sandro, Andrea Lauterio, Riccardo De Carlis, Samuele Frassoni, Antonio Rampoldi, Bruno Tuscano, Vincenzo Bagnardi, Angelo Vanzulli, and Luciano De Carlis. "Surgical Resection vs. Percutaneous Ablation for Single Hepatocellular Carcinoma: Exploring the Impact of Li-RADS Classification on Oncological Outcomes." Cancers 13, no. 7 (April 1, 2021): 1671. http://dx.doi.org/10.3390/cancers13071671.

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Background: Single hepatocellular carcinoma (HCC) benefits from surgical resection (SR) or US-guided percutaneous ablation (PA), although the best approach is still debated. We evaluated the impact of Li-RADS classification on the oncological outcomes of SR vs. PA as single HCC first-line treatment. Methods: We retrospectively and blindly classified treatment-naïve single HCC that underwent SR or PA between 2010 and 2016 according to Li-RADS protocol. Overall survival (OS), recurrence free survival (RFS) and local recurrence after SR and PA were compared for each Li-RADS subclass before and after propensity-score matching (PS-M). Results: Considering the general population, SR showed better 5-year OS (68.3% vs. 52.2%; p = 0.049) and RFS (42.5% vs. 29.8%; p = 0.002), with lower incidence of local recurrence (8.2% vs. 44.4%; p < 0.001), despite a significantly higher frequency of clinically-relevant complications (12.8% vs. 1.9%; p = 0.002) and a higher Comprehensive Complication Index (12.1 vs. 2.2; p < 0.001). Focusing on different Li-RADS subclasses, we highlighted better 5-year OS (67.1% vs. 46.2%; p = 0.035), RFS (45.0% vs. 27.0% RFS; p < 0.001) and lower incidence of local recurrence (9.7% vs. 48.6%; p < 0.001) after SR for Li-RADS-5 HCCs, while these outcomes did not differ for Li-RADS-3/4 subclasses; such results were confirmed after PS-M. Conclusions: Our analysis suggests a potential prognostic role of Li-RADS classification, supporting SR over PA especially for Li-RADS-5 single HCC.

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13

Borofsky, Samuel, Jay Karajgikar, Christopher Roth, and Sandeep Deshmukh. "Liver Imaging Reporting and Data System Classification of Hepatocellular Carcinoma: Implications for Clinical Management." Digestive Disease Interventions 01, no. 02 (June 2017): 083–93. http://dx.doi.org/10.1055/s-0037-1603562.

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AbstractAs the incidence of hepatocellular carcinoma (HCC) continues to increase worldwide, the role imaging plays in management continues to gain clinical importance. Multiple entry points exist for patients in the scheme of diagnosis and treatment of HCC and non-HCC malignancies. Further complicating this scheme is the lack of standardization in the language used for diagnostic imaging and management recommendations. The Liver Imaging Reporting and Data System (LI-RADS) was created to improve communication between clinicians and management teams. LI-RADS serves to standardize reports, improving physician satisfaction and aiding in management decisions across the continuum of care of these patients. Furthermore, LI-RADS provides technical specifications across multiple imaging modalities for screening and follow-up examinations, with the end goal of curing the disease or prolonging survival. In this review, the LI-RADS algorithm will be expanded upon, as well as its utility for various treatment options using the standardized LI-RADS lexicon. Additionally, pitfalls and non-HCC malignancies will also be addressed with resultant improvement in reproducibility of radiology reports that guide therapeutic management.

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14

Li, Lingling, Yixin Hu, Jing Han, Qing Li, Chuan Peng, and Jianhua Zhou. "Clinical Application of Liver Imaging Reporting and Data System for Characterizing Liver Neoplasms: A Meta-Analysis." Diagnostics 11, no. 2 (February 17, 2021): 323. http://dx.doi.org/10.3390/diagnostics11020323.

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The Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system for standardizing liver imaging in patients at risk of developing hepatocellular carcinoma (HCC). We aimed to determine the diagnostic performance of LI-RADS category 5 (LR5) for diagnosing HCC and LI-RADS category M (LRM) for characterizing other non-HCC malignancies (OM) using contrast-enhanced ultrasound (CEUS) and computed tomography (CT)/magnetic resonance imaging (MRI). Multiple databases were searched for articles evaluating the diagnostic accuracy of CEUS LI-RADS and/or CT/MRI LI-RADS. A random-effects model was adopted to synthesize the summary estimates of the diagnostic accuracy of LR5 for diagnosing HCC and LRM for characterizing OM using CEUS and CT/MRI. The pooled sensitivity and specificity of CEUS LR5 for the diagnosis of HCC were 69% and 93%, respectively. The pooled sensitivity was 67% and the specificity, 93% of CT/MRI LR5 for HCC diagnosis. There was no significant difference between the overall diagnostic accuracy for HCC diagnosis of CEUS LR5 and that of CT/MRI LR5 in terms of diagnostic odds ratio (DOR) (p = 0.55). The sensitivity was 84% with a specificity of 90% in the CEUS LRM for characterizing OM, while the sensitivity and specificity of CT/MRI LRM for characterizing OM was 63% and 95%. The DOR of CEUS LRM for characterizing OM was higher than that of CT/MRI LRM without significant difference (50.59 vs. 36.06, p = 0.34). This meta-analysis indicated that CEUS LI-RADS is qualified to characterize HCC and OM and may provide complementary information on liver nodules to CT/MRI LI-RADS.

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15

Elmohr, Mohab, Khaled M. Elsayes, and Victoria Chernyak. "LI‐RADS: Review and updates." Clinical Liver Disease 17, no. 3 (March 2021): 108–12. http://dx.doi.org/10.1002/cld.991.

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16

Kielar, Ania Z., Victoria Chernyak, Mustafa R. Bashir, Richard K. Do, Kathryn J. Fowler, Donald G. Mitchell, Milena Cerny, et al. "LI-RADS 2017: An update." Journal of Magnetic Resonance Imaging 47, no. 6 (April 6, 2018): 1459–74. http://dx.doi.org/10.1002/jmri.26027.

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17

Lee, Sunyoung, Seung-seob Kim, Dong ryul Chang, Hyerim Kim, and Myeong-Jin Kim. "Comparison of LI-RADS 2018 and KLCA-NCC 2018 for noninvasive diagnosis of hepatocellular carcinoma using magnetic resonance imaging." Clinical and Molecular Hepatology 26, no. 3 (July 1, 2020): 340–51. http://dx.doi.org/10.3350/cmh.2020.0004.

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Background/Aims: This study aimed to compare the diagnostic performances of Liver Imaging Reporting and Data System (LI-RADS) 2018 and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) 2018 criteria on magnetic resonance imaging (MRI) for the noninvasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients.Methods: This retrospective study included 273 treatment-naïve patients (71 patients with extracellular contrast agent [ECA]-MRI and 202 patients with hepatobiliary agent [HBA]-MRI; 352 lesions including 263 HCCs) with high risk of HCC who underwent contrast-enhanced MRI between 2016 and 2017. Two readers evaluated all lesions according to the criteria of LI-RADS 2018 and KLCA-NCC 2018. The per-lesion diagnostic performances were compared using the generalized estimating equation method.Results: On ECA-MRI, the sensitivity and specificity of LI-RADS 2018 and KLCA-NCC 2018 were not significantly different (LR-5 vs. definite HCC: 75.8% vs. 69.4%, <i>P</i>=0.095 and 95.8% vs. 95.8%, <i>P</i>>0.999; LR-5/4 vs. definite/probable HCC: 87.1% vs.83.9%, P=0.313 and 87.5% vs. 91.7%, <i>P</i>=0.307). On HBA-MRI, definite HCC of KLCA-NCC 2018 showed significantly higher sensitivity (79.1% vs. 68.2%, <i>P</i><0.001) than LR-5 of LI-RADS 2018 without a significant difference in specificity (93.9% vs. 95.4%, <i>P</i>=0.314). Definite/probable HCC of KLCA-NCC 2018 had higher specificity (92.3% vs. 80.0%, <i>P</i>=0.003) than LR-5/4 of LI-RADS 2018. The sensitivity was lower for definite/probable HCC than for LR-5/4 without statistical significance (85.6% vs. 88.1%, <i>P</i>=0.057).Conclusions: On ECA-MRI, LI-RADS 2018 and KLCA-NCC 2018 showed comparable diagnostic performances. On HBA-MRI, definite HCC of KLCA-NCC 2018 provided better sensitivity than LR-5 category of LI-RADS 2018 without compromising the specificity, while definite/probable HCC of KLCA-NCC 2018 revealed higher specificity than LR-5/4 of LI-RADS 2018 for diagnosing HCC.

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Caraiani, Cosmin, Bianca Boca, Vlad Bura, Zeno Sparchez, Yi Dong, and Christoph Dietrich. "CT/MRI LI-RADS v2018 vs. CEUS LI-RADS v2017—Can Things Be Put Together?" Biology 10, no. 5 (May 6, 2021): 412. http://dx.doi.org/10.3390/biology10050412.

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Different LI-RADS core documents were released for CEUS and for CT/MRI. Both documents rely on major and ancillary diagnostic criteria. The present paper offers an exhaustive comparison of the two documents focusing on the similarities, but especially on the differences, complementarity, and added value of imaging techniques in classifying liver nodules in cirrhotic livers. The major diagnostic criteria are defined, and the sensitivity and specificity of each major diagnostic criteria are presented according to the literature. The existing differences between techniques in assessing the major diagnostic features can be then exploited in order to ensure a better classification and a better clinical management of liver nodules in cirrhotic livers. Ancillary features depend on the imaging technique used, and their presence can upgrade or downgrade the LI-RADS score of an observation, but only as far as LI-RADS 4. MRI is the imaging technique that provides the greatest number of ancillary features, whereas CEUS has fewer ancillary features than other imaging techniques. In the final part of the manuscript, some recommendations are made by the authors in order to guidephysicians as to when adding another imaging technique can be helpful in managing liver nodules in cirrhotic livers.

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Terzi, Eleonora, Alice Giamperoli, Massimo Iavarone, Simona Leoni, Ludovico De Bonis, Alessandro Granito, Antonella Forgione, Francesco Tovoli, and Fabio Piscaglia. "Prognosis of Single Early-Stage Hepatocellular Carcinoma (HCC) with CEUS Inconclusive Imaging (LI-RADS LR-3 and LR-4) Is No Better than Typical HCC (LR-5)." Cancers 14, no. 2 (January 11, 2022): 336. http://dx.doi.org/10.3390/cancers14020336.

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The American College of Radiology (ACR) released the Liver Imaging Report and Data System (LI-RADS) scheme, which categorizes hepatic nodules in risk classes from LR-1 to LR-5 (according to the degree of risk to be HCC) and LR-M (probable malignancy not specific for HCC). The aim of this study was to test whether HCC with different LR patterns on CEUS have different overall survival (OS) and recurrence-free survival (RFS). We retrospectively enrolled 167 patients with the first definitive diagnosis of single HCC (by using CT/MRI or histological techniques if CT/MRI were inconclusive) for whom CEUS examination was available. The median size of HCC lesions was 2.2 cm (range 1.0–7.2 cm). According to CEUS LI-RADS classification, 28 patients were in LR-3, 48 in LR-4, 83 in LR-5, and 8 in LR-M. Patient liver function and nodule characteristics were not statistically different between CEUS LI-RADS classes. Using univariate analysis, CEUS LI-RADS class was not found to be a predictor of survival (p = 0.347). In conclusion, HCC showing the CEUS LI-RADS classes LR-3 and LR-4 have no better clinical outcome than typical HCC. Such data support the EASL policy, aimed at conclusive diagnostic investigations of indeterminate nodules up to obtaining histological proof to avoid leaving aggressive HCC not timely treated.

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Pereira, Rita de Cassia Ribeiro, Carolina Augusta Modena Heming, Thiago Ramos Tejo, Thais Cristina Lima de Oliveira, Rita do Socorro Uchoa da Silva, and Daniella Braz Parente. "Use of the LI-RADS classification in patients with cirrhosis due to infection with hepatitis B, C, or D, or infected with hepatitis B and D." Radiologia Brasileira 53, no. 1 (February 2020): 14–20. http://dx.doi.org/10.1590/0100-3984.2018.0077.

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Abstract Objective: To evaluate liver lesions, in accordance with the LI-RADS classification, using contrast-enhanced multiphase dynamic computed tomography in patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, as well as to determine the level of agreement between radiologists. Materials and Methods: We evaluated 38 patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, all of whom underwent contrast-enhanced multiphase dynamic computed tomography. For each examination, two radiologists selected up to three hepatic lesions, categorizing them in accordance with the LI-RADS classification and evaluating signs of chronic liver disease and portal hypertension. To determine the level of agreement between radiologists, we calculated the kappa statistic (κ) . Results: Radiologist 1 and radiologist 2 selected 56 and 48 liver lesions, respectively. According to radiologist 1 and radiologist 2, respectively, 27 (71%) and 23 (61%) of the 38 patients had at least one liver lesion; 13 (34%) and 12 (32%) had a LI-RADS 5 lesion (κ = 0.821); 19 (50%) and 16 (42%) had a hypervascular lesion (κ = 0.668); and 30 (79%) and 24 (63%) had splenomegaly (κ = 0.503). Both radiologists identified chronic liver disease in 31 (82%) of the patients (κ = 1.00). Conclusion: Lesions categorized as LI-RADS 5 were detected in approximately 32% of the patients, with almost perfect agreement between the radiologists. The level of agreement was substantial or moderate for the other LI-RADS categories.

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Boatright, Christine, Jessica Peterson, Vanessa L. Williams, Shaun Best, and Ryan Ash. "LI-RADS v2018: utilizing ancillary features on gadoxetate-enhanced MRI to modify final LI-RADS category." Abdominal Radiology 45, no. 10 (March 18, 2020): 3136–43. http://dx.doi.org/10.1007/s00261-020-02479-6.

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Pan, Jia-Min, Wei Chen, Yan-Ling Zheng, Mei-Qing Cheng, Dan Zeng, Hui Huang, Yang Huang, et al. "Tumor size-based validation of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) 2017 for hepatocellular carcinoma characterizing." British Journal of Radiology 94, no. 1126 (October 1, 2021): 20201359. http://dx.doi.org/10.1259/bjr.20201359.

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Objectives: To validate the efficacy of contrast-enhanced ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) and its major features in diagnosing hepatocellular carcinoma (HCC) of different sizes in high-risk patients. Methods: Between January 2014 and December 2015, a total of 545 untreated liver nodules were included. These liver nodules were divided into two groups (<20 mm and ≥20 mm). Each nodule was classified based on CEUS LI-RADS. The diagnostic performance comparison was assessed by the chi-square test, with pathology results as the golden criterion. Results: The accuracy, sensitivity, specificity, and positive predictive value (PPV) of CEUS LR-5 criteria in <20 mm group vs ≥20 mm group in diagnosing HCC were 60.5% vs 59.8%, 55.6% vs 57.6%, 85.7% vs 88.6 and 95.2% vs 98.5%, respectively, without significant difference (all p > 0.05). The accuracy, sensitivity and PPV of LR5/M for malignancy in <20 mm group were lower than in ≥20 mm group, with values of 79.1% vs 95.0%, 84.2% vs 95.7 and 91.4% vs 99.2%, respectively (p < 0.05). Conclusions: The CEUS LI-RADS has a comparable performance for diagnosing HCC between lesions ≥ 20 mm and <20 mm. For diagnosing malignancy including HCC, it has a higher efficacy for lesions ≥ 20 mm than <20 mm. Advances in knowledge: 1.For diagnosing HCC, CEUS LI-RADS has comparable performances between lesions ≥ 20 mm and <20 mm. 2. For diagnosing malignancy including HCC, CEUS LI-RADS has a higher efficacy for lesions ≥ 20 mm than <20 mm.

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Kierans, Andrea S., Christopher Song, Alexander Gavlin, Alexandra Roudenko, Lina Lu, Gulce Askin, and Elizabeth M. Hecht. "Diagnostic Performance of LI-RADS Version 2018, LI-RADS Version 2017, and OPTN Criteria for Hepatocellular Carcinoma." American Journal of Roentgenology 215, no. 5 (November 2020): 1085–92. http://dx.doi.org/10.2214/ajr.20.22772.

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Rosiak, Grzegorz, Joanna Podgorska, Edyta Rosiak, and Andrzej Cieszanowski. "Comparison of LI-RADS v.2017 and ESGAR Guidelines Imaging Criteria in HCC Diagnosis Using MRI with Hepatobiliary Contrast Agents." BioMed Research International 2018 (July 15, 2018): 1–6. http://dx.doi.org/10.1155/2018/7465126.

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Purpose. The purpose of this study was to assess and compare diagnostic ability of LI-RADS (LR) v. 2017 and ESGAR guidelines in hepatocellular carcinoma (HCC) diagnosis using MRI with hepatobiliary contrast agents.Methods. Seventy pathologically confirmed lesions in 32 patients (24 males and 8 females) who had MRI with hepatobiliary contrast done before surgery or biopsy were reviewed retrospectively. Six lesions were <10mm, 31 lesions 10-19mm, and 33 lesions ≥20mm. Two readers assessed all lesions according to LI-RADS v.2017 criteria and ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents. Statistical analysis was performed to compare diagnostic ability of both guidelines including receiver operative curves (ROC) and area under curve (AUC).Results. For LR ≥ 4 sensitivity, specificity, accuracy, and AUC were 96%, 75%, 88.6%, and 85.5, respectively. For LR5 they were 74%, 95%, 80%, and 84.5, respectively. For ESGAR criteria with major and additional features, they were 88%, 75%, 84.3%, and 81.5, respectively. For ESGAR criteria only with major features they were 78%, 80%, 78.6%, and 79, respectively. AUC analysis revealed that overall diagnostic ability of LI-RADS was higher than ESGAR but the results did not show statistical significance.Conclusions. Both LI-RADS and ESGAR guidelines presented high diagnostic ability in HCC diagnosis of MRI studies with hepatobiliary contrast agents. More complex LI-RADS criteria performed better than ESGAR guidelines and it may justify extra effort that needs to be put in the report. However, the results were not statistically different and the simplicity of the ESGAR guidelines should also be taken into consideration.

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Takahashi, Hiroshi, Katsutoshi Sugimoto, Naohisa Kamiyama, Kentaro Sakamaki, Tatsuya Kakegawa, Takuya Wada, Yusuke Tomita, et al. "Noninvasive Diagnosis of Hepatocellular Carcinoma on Sonazoid-Enhanced US: Value of the Kupffer Phase." Diagnostics 12, no. 1 (January 7, 2022): 141. http://dx.doi.org/10.3390/diagnostics12010141.

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The aim of this study was to compare the diagnostic performance of Contrast-Enhanced US Liver Imaging Reporting and Data System (CEUS LI-RADS) version 2017, which includes portal- and late-phase washout as a major imaging feature, with that of modified CEUS LI-RADS, which includes Kupffer-phase findings as a major imaging feature. Participants at risk of hepatocellular carcinoma (HCC) with treatment-naïve hepatic lesions (≥1 cm) were recruited and underwent Sonazoid-enhanced US. Arterial phase hyperenhancement (APHE), washout time, and echogenicity in the Kupffer phase were evaluated using both criteria. The diagnostic performance of both criteria was analyzed using the McNemar test. The evaluation was performed on 102 participants with 102 lesions (HCCs (n = 52), non-HCC malignancies (n = 36), and benign (n = 14)). Among 52 HCCs, non-rim APHE was observed in 92.3% (48 of 52). By 5 min, 73.1% (38 of 52) of HCCs showed mild washout, while by 10 min or in the Kupffer phase, 90.4% (47 of 52) of HCCs showed hypoenhancement. The sensitivity (67.3%; 35 of 52; 95% CI: 52.9%, 79.7%) of modified CEUS LI-RADS criteria was higher than that of CEUS LI-RADS criteria (51.9%; 27 of 52; 95% CI: 37.6%, 66.0%) (p = 0.0047). In conclusion, non-rim APHE with hypoenhancement in the Kupffer phase on Sonazoid-enhanced US is a feasible criterion for diagnosing HCC.

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Rodgers, Shuchi K., David T. Fetzer, and Yuko Kono. "Using LI‐RADS With Contrast‐Enhanced Ultrasound." Clinical Liver Disease 17, no. 3 (March 2021): 154–58. http://dx.doi.org/10.1002/cld.1077.

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Cunha, Guilherme Moura, Claude B. Sirlin, and Kathryn J. Fowler. "Imaging diagnosis of hepatocellular carcinoma: LI-RADS." Chinese Clinical Oncology 9, no. 3 (June 2020): 6. http://dx.doi.org/10.21037/cco-20-107.

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Yano, Motoyo. "Invited Commentary: Contextualization of LI-RADS Reporting." RadioGraphics 41, no. 5 (September 2021): E151—E152. http://dx.doi.org/10.1148/rg.2021210057.

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Ueshima, Eisuke, Keitaro Sofue, and Takamichi Murakami. "Imaging Diagnosis of HCC Featuring LI-RADS." Kanzo 62, no. 5 (May 1, 2021): 229–39. http://dx.doi.org/10.2957/kanzo.62.229.

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Tang, An, Kathryn J. Fowler, Victoria Chernyak, William C. Chapman, and Claude B. Sirlin. "LI-RADS and transplantation for hepatocellular carcinoma." Abdominal Radiology 43, no. 1 (June 13, 2017): 193–202. http://dx.doi.org/10.1007/s00261-017-1210-8.

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Chernyak, Victoria, Cynthia S. Santillan, Demetri Papadatos, and Claude B. Sirlin. "LI-RADS® algorithm: CT and MRI." Abdominal Radiology 43, no. 1 (July 10, 2017): 111–26. http://dx.doi.org/10.1007/s00261-017-1228-y.

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Santillan, Cynthia, Victoria Chernyak, and Claude Sirlin. "LI-RADS categories: concepts, definitions, and criteria." Abdominal Radiology 43, no. 1 (October 16, 2017): 101–10. http://dx.doi.org/10.1007/s00261-017-1334-x.

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Sirlin, Claude B. "The LI-RADS adventure—a personal statement." Abdominal Radiology 43, no. 1 (December 27, 2017): 1–2. http://dx.doi.org/10.1007/s00261-017-1386-y.

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Sirlin, Claude B., Ania Z. Kielar, An Tang, and Mustafa R. Bashir. "LI-RADS: a glimpse into the future." Abdominal Radiology 43, no. 1 (January 2018): 231–36. http://dx.doi.org/10.1007/s00261-017-1448-1.

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Fraum, Tyler J., Roberto Cannella, Daniel R. Ludwig, Richard Tsai, Muhammad Naeem, Maverick LeBlanc, Amber Salter, et al. "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." European Radiology 30, no. 2 (October 25, 2019): 996–1007. http://dx.doi.org/10.1007/s00330-019-06448-6.

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Wang, Peihua, Fang Nie, Tiantian Dong, Dan Yang, Ting Liu, and Guojuan Wang. "Diagnostic Value of CEUS LI-RADS Version 2017 in Differentiating AFP-Negative Hepatocellular Carcinoma from Other Primary Malignancies of the Liver." Diagnostics 11, no. 12 (December 1, 2021): 2250. http://dx.doi.org/10.3390/diagnostics11122250.

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Purpose: To explore the diagnostic value of Contrast-enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 (CEUS LI-RADS v2017) in differentiating alpha-fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) from other primary malignancies (OM) of the liver. Methods: The data of 99 patients with primary liver malignant tumors confirmed by surgical pathology and AFP-negative from January 2018 to January 2021 were retrospectively analyzed, and the lesions were divided into 61 cases in the AFP-negative HCC group and 38 cases in the OM group according to the pathological findings, the CEUS features of the lesions were analyzed and the lesions were classified according to the CEUS LI-RADS v2017. Comparison of CEUS features between the two groups was performed using the χ2 test. The sensitivity, specificity, positive predictive value, negative predictive value, and coincidence rate of CEUS LI-RADS v2017 for the diagnosis of AFP-negative HCC and OM were calculated using pathological findings as the gold standard. Results: The differences in features of arterial phase enhancement and wash-out between the HCC and OM groups were statistically significant (p < 0.05). The sensitivity of diagnosing HCC by LR-5 was 62.3% and the specificity was 92.1%. The sensitivity of diagnosing OM by LR-M was 92.1% and the specificity was 83.6%. Conclusions: When AFP is negative in patients with intrahepatic focal lesions, LR-5 has high specificity but low sensitivity in the diagnosis of HCC, and LR-M has high sensitivity and specificity in the diagnosis of OM. CEUS LI-RADS is a tool to differentiate AFP-negative HCC and OM effectively.

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Lee, Yi‐Te, Jasmine J. Wang, Yazhen Zhu, Vatche G. Agopian, Hsian‐Rong Tseng, and Ju Dong Yang. "Diagnostic Criteria and LI‐RADS for Hepatocellular Carcinoma." Clinical Liver Disease 17, no. 6 (June 2021): 409–13. http://dx.doi.org/10.1002/cld.1075.

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Dietrich, Christoph F., Yi Dong, Yuko Kono, Cosmin Caraiani, Claude B. Sirlin, Xin-Wu Cui, and An Tang. "LI-RADS ancillary features on contrast-enhanced ultrasonography." Ultrasonography 39, no. 3 (July 1, 2020): 221–28. http://dx.doi.org/10.14366/usg.19052.

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Hope, Thomas A., Kathryn J. Fowler, Claude B. Sirlin, Eduardo A. C. Costa, Judy Yee, Benjamin M. Yeh, and Jay P. Heiken. "Hepatobiliary agents and their role in LI-RADS." Abdominal Imaging 40, no. 3 (October 7, 2014): 613–25. http://dx.doi.org/10.1007/s00261-014-0227-5.

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Siedlikowski, Stefan T., Ania Z. Kielar, Eleanor L. Ormsby, Bijan Bijan, and Christopher Kagay. "Implementation of LI-RADS into a radiological practice." Abdominal Radiology 43, no. 1 (June 20, 2017): 179–84. http://dx.doi.org/10.1007/s00261-017-1219-z.

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Cerny, Milena, Victoria Chernyak, Damien Olivié, Jean-Sébastien Billiard, Jessica Murphy-Lavallée, Ania Z. Kielar, Khaled M. Elsayes, et al. "LI-RADS Version 2018 Ancillary Features at MRI." RadioGraphics 38, no. 7 (November 2018): 1973–2001. http://dx.doi.org/10.1148/rg.2018180052.

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Katrich, A. N., V. A. Porkhanov, and N. S. Ryabin. "Efficacy evaluation of the CEUS-LI-RADS-v2017 system in differential diagnosis of liver tumors." Medical Visualization, no. 4 (December 26, 2019): 57–67. http://dx.doi.org/10.24835/1607-0763-2019-4-57-67.

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Objective: efficacy evaluation of the CEUS LI RADS v2017® system for differential diagnosis of liver tumors in patients with and without cirrhosis.Materials and methods. Retrospective analysis of diagnostic results of the 165 patients with liver tumors (177 nodules) was done. All patients underwent CEUS with results interpretation in accordance to the CEUS LIRADSv2017 ® criteria. Patients were divided into 2 groups based on clinical and morphological data. Group 1 included 62 patients with cirrhosis and/or CVH. Group 2 included 110 patients without risk factors for HCC.Results. Diagnostic efficiency of CEUS LI RADS v2017® for HCC identification was: group 1 – Se – 100%, Sp – 88%, Ac – 95.5%; group 2 – Se – 100%, Sp – 68.8%, Ac – 72.7%; general group Se – 100%, Sp – 72.2%, Ac – 81.4%. In the 2nd group, 21 out of 22 neoplasms, confirmed morphologically as FNH, we classified as LR 4. By applying benign character and specific contrasting patterns of FNG, they were transferred from LR 4 to LR 3. This allowed to increase sensitivity and specificity of differential diagnosis in group 2 (Se – 100%, Sp – 90.6%, Ac – 91.8%) and in general group (Se – 100%, Sp – 90.1%, Ac – 93.2%). Diagnostic efficiency of the criteria for non hepatocellular malignant neoplasms (LR M) was: group 1 – Se – 77.8%, Sp – 100%, Ac – 97%; group 2 – Se – 90%, Sp – 96.7%, Ac – 93.6%; general group- Se – 88.1%, Sp – 98.3%, Ac – 94.9%.Conclusion. Our study confirmed high accuracy of the CEUS LI RADS v2017® system in the differential diagnosis of focal liver tumors. Modification of the system (in particular, transfer of typical FNG forms from the LR 4 category) will make it possible to increase the accuracy of diagnostics by 20%. It will allow to use the LI RADS v2017® system for interpretation CEUS not only among patients with liver cirrhosis, but also in a general group without risk factors of GCC.

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Park, Jae Hyon, Yong Eun Chung, Nieun Seo, Jin-Young Choi, Mi-Suk Park, and Myeong-Jin Kim. "Gadoxetic acid-enhanced MRI of hepatocellular carcinoma: Diagnostic performance of category-adjusted LR-5 using modified criteria." PLOS ONE 15, no. 11 (November 13, 2020): e0242344. http://dx.doi.org/10.1371/journal.pone.0242344.

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The Liver Imaging Reporting and Data System (LI-RADS) is widely adopted for the noninvasive diagnosis of hepatocellular carcinoma (HCC). Herein, possible strategies to improve the diagnostic performance of LR-5 without reducing specificity for HCC were investigated. This retrospective study included 792 patients who underwent gadoxetate disodium-enhanced magnetic resonance imaging. Hepatic observations were categorized according to LI-RADS v2018 and categories were readjusted by upgrading LR4 to LR5 using ancillary features, arterial phase hyperenhancement (APHE) interpreted with subtraction images, indication of no washout when APHE was absent, extension of washout to the transitional phase, and subthreshold growth as a major feature. Based on LI-RADS v2018, LR-5 showed a sensitivity of 71.9% and a specificity of 97.9% for the diagnosis of HCC. Category-readjusted LR-5 after upgrading LR-4 to LR-5 using ancillary features favoring HCC in particular, subthreshold growth as a major feature, extending washout to transitional phase and APHE interpreted using subtraction images showed significantly increased sensitivity (P<0.001) without decreased specificity (Ps>0.05). The sensitivity of LR-5 can be improved without loss of specificity via category readjustment using AFs favoring HCC in particular, subthreshold growth as a major feature, extending washout to transitional phase and APHE interpreted with subtraction images.

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Schellhaas, B., M. Hammon, D. Strobel, L. Pfeifer, C. Kielisch, RS Goertz, A. Cavallaro, et al. "Interobserver- und Verfahrens-Übereinstimmung für standardisierte Diagnose-Algorithmen für das Heptozelluläre Karzinom bei Hochrisikopatienten – CEUS-LI-RADS versus MRT-LI-RADS." Zeitschrift für Gastroenterologie 56, no. 08 (August 2018): e193-e193. http://dx.doi.org/10.1055/s-0038-1668637.

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Sugimoto, Katsutoshi, Tatsuya Kakegawa, Hiroshi Takahashi, Yusuke Tomita, Masakazu Abe, Yu Yoshimasu, Hirohito Takeuchi, Yoshitaka Kasai, and Takao Itoi. "Usefulness of Modified CEUS LI-RADS for the Diagnosis of Hepatocellular Carcinoma Using Sonazoid." Diagnostics 10, no. 10 (October 15, 2020): 828. http://dx.doi.org/10.3390/diagnostics10100828.

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The Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) was introduced for classifying suspected hepatocellular carcinoma (HCC). However, it cannot be applied to Sonazoid. We assessed the diagnostic usefulness of a modified CEUS LI-RADS for HCC and non-HCC malignancies based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Patients with chronic liver disease at risk for HCC were evaluated retrospectively. Nodules ≥1 cm with arterial phase hyperenhancement, no early washout (within 60 s), and contrast defects in the Kupffer phase were classified as LR-5. Nodules showing early washout, contrast defects in the Kupffer phase, and/or rim enhancement were classified as LR-M. A total of 104 nodules in 104 patients (median age: 70.0 years; interquartile range: 54.5–78.0 years; 74 men) were evaluated. The 48 (46.2%) LR-5 lesions included 45 HCCs, 2 high-flow hemangiomas, and 1 adrenal rest tumor. The PPV of LR-5 for HCC was 93.8% (95% confidence interval (CI): 82.8–98.7%). The 22 (21.2%) LR-M lesions included 16 non-HCC malignancies and 6 HCCs. The PPV of LR-M for non-HCC malignancies, including six intrahepatic cholangiocarcinomas, was 100% (95% CI: 69.8–100%). In conclusion, in the modified CEUS LI-RADS for Sonazoid, LR-5 and LR-M are good predictors of HCC and non-HCC malignancies, respectively.

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Rosiak, Grzegorz, Joanna Podgórska, Edyta Rosiak, and Andrzej Cieszanowski. "CT/MRI LI-RADS v2017 – review of the guidelines." Polish Journal of Radiology 83 (2018): 355–65. http://dx.doi.org/10.5114/pjr.2018.78391.

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Karlas, T. "LI-RADS-CEUS: Ultraschall-basierte Klassifikation HCC-suspekter Leberraumforderungen." Zeitschrift für Gastroenterologie 55, no. 05 (March 15, 2017): 507–8. http://dx.doi.org/10.1055/s-0043-103327.

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Chernyak, Victoria, An Tang, Milana Flusberg, Demetri Papadatos, Bijan Bijan, Yuko Kono, and Cynthia Santillan. "LI-RADS® ancillary features on CT and MRI." Abdominal Radiology 43, no. 1 (June 24, 2017): 82–100. http://dx.doi.org/10.1007/s00261-017-1220-6.

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Shropshire, Erin L., Mohammad Chaudhry, Chad M. Miller, Brian C. Allen, Erol Bozdogan, Diana M. Cardona, Lindsay Y. King, et al. "LI-RADS Treatment Response Algorithm: Performance and Diagnostic Accuracy." Radiology 292, no. 1 (July 2019): 226–34. http://dx.doi.org/10.1148/radiol.2019182135.

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Furlan, Alessandro. "New Progress toward Validation of LI-RADS Version 2018." Radiology 291, no. 1 (April 2019): 81–82. http://dx.doi.org/10.1148/radiol.2019182890.

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