Diagnostic performance of LI-RADS for MRI and CT detection of HCC: A systematic review and diagnostic meta-analysis

Liang, Yingying; Xu, Fan; Guo, Yuan; Lai, Lisha; Jiang, Xinqing; Wei, Xinhua; Wu, Hongzhen; Wang, Jin

doi:10.1016/j.ejrad.2020.109404

Cited by 35 publications

(22 citation statements)

References 38 publications

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“…Most of the radiological features of CHCC and NCHCC are similar, except, of course, for the background of cirrhosis among the CHCC patients. Multiple imaging modalities are available, including ultrasound (US), contrast enhanced US, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography scan[ 81 ], CT-based radiomics nomogram [ 82 , 83 ], and angiography-assisted CT hepatic angiography[ 84 , 85 ]. Classical CT/MRI findings are arterial phase hyper-enhancement (due to hepatic arterial supply of the tumor), followed by portal venous washout.…”

Section: Diagnosismentioning

confidence: 99%

Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

Perisetti

Goyal

Thandassery

et al. 2021

WJG

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Primary liver cancers carry significant morbidity and mortality. Hepatocellular carcinoma (HCC) develops within the hepatic parenchyma and is the most common malignancy originating from the liver. Although 80% of HCCs develop within background cirrhosis, 20% may arise in a non-cirrhotic milieu and are referred to non-cirrhotic-HCC (NCHCC). NCHCC is often diagnosed late due to lack of surveillance. In addition, the rising prevalence of non-alcoholic fatty liver disease and diabetes mellitus have increased the risk of developing HCC on non-cirrhotic patients. Viral infections such as chronic Hepatitis B and less often chronic hepatitis C with advance fibrosis are associated with NCHCC. NCHCC individuals may have Hepatitis B core antibodies and occult HBV infection, signifying the role of Hepatitis B infection in NCHCC. Given the effectiveness of current antiviral therapies, surgical techniques and locoregional treatment options, nowadays such patients have more options and potential for cure. However, these lesions need early identification with diagnostic models and multiple surveillance strategies to improve overall outcomes. Better understanding of the NCHCC risk factors, tumorigenesis, diagnostic tools and treatment options are critical to improving prognosis and overall outcomes on these patients. In this review, we aim to discuss NCHCC epidemiology, risk factors, and pathogenesis, and elaborate on NCHCC diagnosis and treatment strategies.

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Section: Diagnosismentioning

confidence: 99%

Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

Perisetti

Goyal

Thandassery

et al. 2021

WJG

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“…The American Association for the Study of Liver Diseases (AASLD) also define the diagnosis of HCC by these criteria, but additionally consider threshold growth as described by Liver Imaging Reporting and Data System (LI-RADS) [3]. The majority of studies investigating the diagnostic accuracy of NIRC are retrospective and the focus has been on the detection of early disease [4,5]. Despite this, the diagnostic criteria have been extended to advanced disease with the consequence that patients with HCC usually embark on systemic therapy without a histological diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit

et al. 2021

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Background Advanced hepatocellular carcinoma (HCC) is commonly diagnosed using non-invasive radiological criteria (NIRC) defined by the European Association for the Study of the Liver or the American Association for the Study of Liver Diseases. In 2017, The National Institute for Clinical Excellence mandated histological confirmation of disease to authorise the use of sorafenib in the UK. Methods This was a prospective multicentre audit in which patients suitable for sorafenib were identified at multidisciplinary meetings. The primary analysis cohort (PAC) was defined by the presence of Child-Pugh class A liver disease and performance status 0–2. Clinical, radiological and histological data were reported locally and collected on a standardised case report form. Results Eleven centres reported 418 cases, of which 361 comprised the PAC. Overall, 76% had chronic liver disease and 66% were cirrhotic. The diagnostic imaging was computed tomography in 71%, magnetic resonance imaging in 27% and 2% had both. Pre-existing histology was available in 45 patients and 270 underwent a new biopsy, which confirmed HCC in 93.4%. Alternative histological diagnoses included cholangiocarcinoma (CC) and combined HCC-CC. In cirrhotic patients, NIRC criteria had a sensitivity of 65.4% and a positive predictive value of 91.4% to detect HCC. Two patients (0.7%) experienced mild post-biopsy bleeding. Conclusion The diagnostic biopsy is safe and feasible for most patients eligible for systemic therapy

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“…A distinctive pattern of hypervascularization followed by wash-out is among the characteristic HCC features included in the Liver Imaging Reporting and Data System (LI-RADS) guidelines, along with size, dimensional increase over time and capsule presence [ 5 ]. The LI-RADS criteria achieved a sensitivity of 86% and specificity of 85% for identifying HCC when lesions received a score of at least three out of five [ 6 ]. In uncertain cases, biopsy may be required for the final diagnosis.…”

Section: Introductionmentioning

confidence: 99%

State of the Art in Artificial Intelligence and Radiomics in Hepatocellular Carcinoma

et al. 2021

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The most common liver malignancy is hepatocellular carcinoma (HCC), which is also associated with high mortality. Often HCC develops in a chronic liver disease setting, and early diagnosis as well as accurate screening of high-risk patients is crucial for appropriate and effective management of these patients. While imaging characteristics of HCC are well-defined in the diagnostic phase, challenging cases still occur, and current prognostic and predictive models are limited in their accuracy. Radiomics and machine learning (ML) offer new tools to address these issues and may lead to scientific breakthroughs with the potential to impact clinical practice and improve patient outcomes. In this review, we will present an overview of these technologies in the setting of HCC imaging across different modalities and a range of applications. These include lesion segmentation, diagnosis, prognostic modeling and prediction of treatment response. Finally, limitations preventing clinical application of radiomics and ML at the present time are discussed, together with necessary future developments to bring the field forward and outside of a purely academic endeavor.

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Diagnostic performance of LI-RADS for MRI and CT detection of HCC: A systematic review and diagnostic meta-analysis

Cited by 35 publications

References 38 publications

Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit

State of the Art in Artificial Intelligence and Radiomics in Hepatocellular Carcinoma

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