CT/MRI LI-RADS v2018 vs. CEUS LI-RADS v2017—Can Things Be Put Together?

Caraiani, Cosmin; Boca, Bianca; Bura, Vlad; Spârchez, Zeno; Dong, Yi; Dietrich, Christoph F.

doi:10.3390/biology10050412

Cited by 16 publications

(15 citation statements)

References 72 publications

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“…7 Comparison between CT/MRI LI-RADS and CEUS LI-RADS for categorization has been previously performed and reported. [8][9][10] The US contrast agents currently available are categorized into two types: pure blood pool contrast agents, such as Lumason (Bracco Diagnostics, Monroe Township, NJ, USA) and Definity (Lantheus Medical Imaging, Billerica, MA, USA) and combined blood pool and Kupffer cell contrast agents, such as Sonazoid (GE Healthcare, Oslo, Norway). Unfortunately, the current version of CEUS LI-RADS (version 2017) is applicable only to the pure blood pool contrast agents but not to the combined blood pool and Kupffer cell agents.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of modified CEUS LI‐RADS with sonazoid and CT/MRI LI‐RADS for diagnosis of hepatocellular carcinoma

Sugimoto

Saito

Shirota

et al. 2022

Hepatology Research

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Aim To compare the diagnostic performance based on the modified CEUS Liver Imaging Reporting and Data System (LI‐RADS), which includes Kupffer‐phase findings as a major imaging feature, with that of CT and MRI (CT/MRI) LI‐RADS for liver nodules in patients at high risk of HCC. Methods A total of 120 patients with 120 nodules were included in this retrospective study. The median size of the lesions was 20.0 mm (interquartile range, 14.0–30.8 mm). Of these lesions, 90.0% (108 of 120) were confirmed as HCCs, 6.7% (8 of 120) were intrahepatic cholangiocarcinomas, 1.7% (2 of 120) were metastases, and 1.7% (2 of 120) were dysplastic nodules. All nodules were diagnosed histopathologically. Each nodule was categorized according to the modified CEUS LI‐RADS and CT/MRI LI‐RADS version 2018. The diagnostic performance and inter‐modality agreement of each criterion was compared. Results The inter‐modality agreement for the modified CEUS LI‐RADS and CT/MRI LI‐RADS was slight agreement (kappa = 0.139, p = 0.015). The diagnostic accuracies of HCCs for the modified CEUS LR‐5 and CT/MRI LR‐5 were 70.0% (95% confidence interval [CI]: 61.0%, 78.0%) versus 70.8% (95% CI: 61.8%, 78.8%) (p = 0.876), respectively. The diagnostic accuracies of non‐HCC malignancies for the modified CEUS LR‐M and CT/MRI LR‐M were 84.2% (95% CI: 76.4%, 90.2%) versus 96.7% (95% CI: 91.7%, 99.1%) (p = 0.002), respectively. Conclusions The diagnostic performance for HCCs on the modified CEUS LR‐5 and CT/MRI LR‐5 are comparable. In contrast, CT/MRI LR‐M has better diagnostic performance for non‐HCC malignancy than that of the modified CEUS LR‐M.

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Section: Introductionmentioning

confidence: 99%

“…American College of Radiology (ACR) also established the CEUS LI‐RADS in 2016 6 and further revised it in 2017 7 . Comparison between CT/MRI LI‐RADS and CEUS LI‐RADS for categorization has been previously performed and reported 8–10 …”

Section: Introductionmentioning

confidence: 99%

Comparison of modified CEUS LI‐RADS with sonazoid and CT/MRI LI‐RADS for diagnosis of hepatocellular carcinoma

Sugimoto

Saito

Shirota

et al. 2022

Hepatology Research

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“…According to the current American Association for the Study of Liver Disease (AASLD) guidelines, for all chronic hepatitis B patients without cirrhosis, HCC surveillance is recommended for Asian men older than 40 years, Asian women older than 50 years, and Africans [ 2 ]. With the progress of liver imaging techniques, the accurate detection of HCC at an early stage has been promoted [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Imaging Features of Hepatocellular Carcinoma in the Non-Cirrhotic Liver with Sonazoid-Enhanced Contrast-Enhanced Ultrasound

et al. 2022

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Purpose: To investigate the Sonazoid-enhanced contrast-enhanced ultrasound (CEUS) features of hepatocellular carcinoma (HCC) in a non-cirrhosis liver background, in comparison to those in liver cirrhosis. Methods: In this retrospective study, 19 patients with surgery and histopathologically proven HCC lesions in non-cirrhosis liver background were included regarding Sonazoid-enhanced CEUS characteristics. Two radiologists evaluated the CEUS features of HCC lesions according to the WFUMB (World Federation of Societies for Ultrasound in Medicine and Biology) guidelines criteria. Thirty-six patients with HCC lesions in liver cirrhosis were included as a control group. Final diagnoses were confirmed by surgery and histopathological results. Results: Liver background of the non-cirrhosis group including normal liver (n = 7), liver fibrosis (n = 11), and alcoholic liver disease (n = 1). The mean size of non-cirrhosis HCC lesions was 60.8 ± 46.8 mm (ranging from 25 to 219 mm). During the arterial phase of Sonazoid-enhanced CEUS, most HCCs in non-cirrhotic liver (94.7%, 18/19) and in cirrhotic liver (83.3%, 30/36) presented non-rim hyperenhancement. During the portal venous phase, HCC lesions in the non-cirrhosis liver group showed relatively early washout (68.4%, 13/19) (p = 0.090). Meanwhile, HCC lesions in liver cirrhosis background showed isoenhancement (55.6%, 20/36). All lesions in the non-cirrhotic liver group showed hypoenhancement in the late phase and the Kupffer phase (100%, 19/19). Five cases of HCC lesions in liver cirrhosis showed isoenhancement during the late phase and hypoenhancement during the Kupffer phase (13.9%, 5/36). The rest of the cirrhotic HCC lesions showed hypoenhancement during the late phase and the Kupffer phase (86.1%, 31/36). Additional hypoenhanced lesions were detected in three patients in the non-cirrhosis liver group and eight patients in the liver cirrhosis group (mean size: 13.0 ± 5.6 mm), which were also suspected to be HCC lesions. Conclusions: Heterogeneous hyperenhancement during the arterial phase as well as relatively early washout are characteristic features of HCC in the non-cirrhotic liver on Sonazoid-enhanced CEUS.

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“…The liver imaging reporting and data system (LI-RADS) is used by radiologists to categorize liver lesions in cirrhotic patients using magnetic resonance imaging (MRI) or computer tomography (CT) in a standardized manner. The ordinal categories range from LR-1 (definitely benign) to LR-5 (definitely HCC), with the additional categories of LR-M for malignancies other than HCC and LR-TIV for tumors in veins [ 7 , 9 , 10 , 11 , 12 , 13 ]. In a cirrhotic liver, lesions ≥ 1 cm in diameter that show an arterial phase hyperenhancement with delayed washout on multiphasic CT or dynamic enhanced MRI scans (the so called “radiological hallmark of HCC” or LR-5) can be adequately diagnosed as HCC without the need for histology [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

HCC or Something Else? Frequency of Various Benign and Malignant Etiologies in Cirrhotic Patients with Newly Detected Focal Liver Lesions in Relation to Different Clinical and Sonographic Parameters

et al. 2022

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Background and Aims: To investigate the frequency of different benign and malignant focal liver lesions (FLLs) in relation to clinical and sonographic features among patients with liver cirrhosis (LC) and newly detected FLLs. Methods: This study was a retrospective analysis of 225 cirrhotic patients with newly detected FLLs who underwent hepatic ultrasound (US) examinations at our university hospital from 2011 to 2022. The diagnosis of FLLs was based on histology and/or consensus radiological criteria, in accordance with the current diagnostic guidelines. The FLLs were classified into benign (bFLLs) or malignant (mFLLs) lesions and the latter group was subclassified into HCC and non-HCC mFLLs. The frequency, clinical parameters, and sonographic features of the different groups were examined and compared. Results: Of the 225 FLLs, 154 (68.4%) were mFLLs and 71 (31.6%) bFLLs. HCC was the most frequent subcategory of FLLs (132; 58.7%). There were (22; 9.8%) non-HCC mFLLs with 11 (4.9%) metastases and 11 (4.9%) non-HCC primary liver tumors. Regenerative nodules (RNs) were the most frequent form of bFLLs (25; 11.1%), followed by simple cysts (22; 9.8%) and hemangiomas (14; 6.2%). The other bFLLs (10; 14.1%) were fat deposition/sparing (5), hematomas (2), abscesses (2), and echinococcal cysts (1). The distribution of bFLLs and HCC and non-HCC mFLLs varied significantly according to the clinical scenarios. HCC mFLLs were more frequent in males (p = 0.001), in those with no history of active non-hepatic primary malignant disease (NHPMD) (p < 0.001), in those with a hepatitis B or C etiology of LC (p = 0.002), when located in the right lobe (p = 0.008), and when portal vein thrombosis was present (p = 0.03). Conclusion: In cirrhotic patients with newly detected FLLs, the non-HCC etiology was more frequently diagnosed in lesions that were located in the left lobe, in females, and in patients with a history of active NHPMD. Thus, the lower frequency of HCC in the abovementioned groups demonstrated that a cautious implementation of the current consensus radiological criteria would be required for these groups, particularly in patients with an active NHPMD, given the fact that the consensus criteria were not validated in these populations. A more active diagnostic approach may ultimately be needed for these patients. Large prospective studies are needed to validate these findings.

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CT/MRI LI-RADS v2018 vs. CEUS LI-RADS v2017—Can Things Be Put Together?

Cited by 16 publications

References 72 publications

Comparison of modified CEUS LI‐RADS with sonazoid and CT/MRI LI‐RADS for diagnosis of hepatocellular carcinoma

Comparison of modified CEUS LI‐RADS with sonazoid and CT/MRI LI‐RADS for diagnosis of hepatocellular carcinoma

Imaging Features of Hepatocellular Carcinoma in the Non-Cirrhotic Liver with Sonazoid-Enhanced Contrast-Enhanced Ultrasound

HCC or Something Else? Frequency of Various Benign and Malignant Etiologies in Cirrhotic Patients with Newly Detected Focal Liver Lesions in Relation to Different Clinical and Sonographic Parameters

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