The Course of LIRADS 3 and 4 Hepatic Abnormalities as Correlated With Explant Pathology: A Single Center Experience.
J Clin Exp Hepatol
; 12(4): 1048-1056, 2022.
Article
en En
| MEDLINE
| ID: mdl-35814502
ABSTRACT
Background and aims:
The Liver Reporting and Data System (LI-RADS) is the standard classification of imaging findings of hepatic abnormalities for hepatocellular carcinoma (HCC) surveillance. We aimed to study the course of LI-RADS 3 and 4 (LR-3 and LR-4) abnormalities through correlations with explant pathology.Methods:
A single center retrospective study of liver transplant recipients between January 2016 and September 2019 with HCC on explant pathology was conducted. Eligible patients were divided into three subgroups based on their LI-RADS classification LR-3/4, LR-5 only, and combination of LR-3/4/5.Results:
There were 116 eligible patients with 99 LR-3/4 observations (60 LR-3 and 39 LR-4); the rest had LR-5 lesions. LR-4 more often than LR-3 observations progressed to LR-5 (36% vs 12%) and with shorter duration during follow-up (median 175 days and 196 days). Mean size growth of LR-3 and LR-4 abnormalities were 2.6 and 3.8 mm; median growth rates were 0.2 and 0.4 mm/month, respectively. Numbers of HCC lesions per explant, largest HCC lesion size, and cumulative size were higher in LR-3/4/5 subgroup than LR-5 subgroup (P = 0.007, 0.007 and 0.006, respectively); 68% of LR-3 and 82% of LR-4 abnormalities were confirmed HCC on explant (P = 0.09).Conclusion:
Compared to LR-3, more LR-4 abnormalities progressed to LR-5 (12% and 36%, respectively) in a shorter time and with faster growth rate. A high proportion of LR-3 and LR-4 lesions (68% and 82%, respectively) were confirmed HCC on explant, raising the question of whether excluding HCC based on radiologic criteria alone is adequate in those with LR-3/4 abnormalities.
AFP, alpha-fetoprotein; BMI, body mass index; CT, computed tomography; HBV, hepatitis b virus; HCC, hepatocellular carcinoma; HCV, hepatitis c virus; LI-RADS, liver reporting and data system; LIRADS classification; LR-3, LI-RADS 3; LR-4, LI-RADS4; LR-5, LI-RADS 5; LT, liver transplantation; MELD-Na, model for end stage liver disease sodium; MRI, magnetic resonance imaging; explant pathology; hepatocellular carcinoma; liver transplant
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Bases de datos:
MEDLINE
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Idioma:
En
Revista:
J Clin Exp Hepatol
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos