LI‐RADS 2017: An update

Kielar, Ania Z.; Chernyak, Victoria; Bashir, Mustafa R.; Richard, K. G.; Fowler, Kathryn J.; Mitchell, Donald G.; Cerny, Milena; Elsayes, Khaled M.; Santillan, Cynthia; Kamaya, Aya; Kono, Yuko; Sirlin, Claude B.; Tang, An

doi:10.1002/jmri.26027

Cited by 37 publications

(23 citation statements)

References 47 publications

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“…This complexity has resulted in the development of several staging algorithms, including RECIST, modified RECIST, and the Liver Reporting and Data System. Scores from these algorithms are frequently revised and are the focus of intense discussions (12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

⁶⁸Ga-Labeled Prostate-Specific Membrane Antigen Is a Novel PET/CT Tracer for Imaging of Hepatocellular Carcinoma: A Prospective Pilot Study

et al. 2018

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Ga-Prostate Specific Membrane Antigen (Ga-PSMA), a positron emission tomography (PET) tracer that was recently introduce for imaging of prostate cancer, may accumulate in other solid tumors including Hepatocellular Carcinoma (HCC). The aim of the study was to assess the potential role of Ga-PSMA PET-Computed Tomography (CT) for imaging of HCC. A prospective pilot study in seven patients with HCC with 41 liver lesions: 37 suspected malignant lesions (tumor lesions) and 4 regenerative nodules. For each liver lesion, uptake of Ga-PSMA andF-FDG uptake were measured [standard uptake value (SUV) and lesion-to-liver background ratios (TBR-SUV)], and correlated with dynamic characteristics (HU and TBR-HU) obtained on contrast enhanced CT data. Immunohistochemistry staining of PSMA in the tumor tissue was analyzed in samples obtained from 5 patients with HCC and compared to control samples from 3 patients with prostate cancer. Thirty-six of the 37 tumor lesions and none of the regenerative nodules showed increasedGa-PSMA uptake while only 10 lesions were F-FDG avid. Based on contrast enhancement, tumor lesions were categorized into 27 homogeneously enhancing lesions, nine lesions with "mosaic" enhancement composed of enhancing and non-enhancing regions in the same lesion and a single non-enhancing lesion, the latter being the only non-Ga-PSMA avid lesion. Using the Mann-Whitney test, Ga-PSMA uptake was found significantly higher in enhancing tumor areas compared to non-enhancing areas and in contrast,F-FDG uptake was higher in non-enhancing areas, P<0.001 for both. Ga-PSMA uptake (TBR SUV) was found to correlate with vascularity (TBR-HU) (Spearman r=0.866, p<0.001). Immunohistochemistry showed intense intra-tumoral microvessel staining for PSMA in HCC, in contrast with cytoplasmic and membranous staining, mainly in the luminal border, in prostate cancer samples. In two of the study patients Ga-PSMA PET-CT identified unexpected extrahepatic metastases. Four regenerative liver nodules showed no increased uptake of either of the PET tracers.Ga-PSMA PET-CT is superior to F-FDG PET-CT in imaging patients with HCC. HCC lesions are more commonly hypervascular taking upGa-PSMA in tumoral micro-vessels. Ga-PSMA PET-CT is a potential novel modality for imaging patients with HCC.

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Section: Discussionmentioning

confidence: 99%

⁶⁸Ga-Labeled Prostate-Specific Membrane Antigen Is a Novel PET/CT Tracer for Imaging of Hepatocellular Carcinoma: A Prospective Pilot Study

et al. 2018

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“…The significance of pretreatment nonmalignant lesions presents a challenge for hepatologists. The LI‐RADS criteria were developed to try and overcome this, but diagnostic uncertainty remains . We have shown that patients with apparently nonmalignant lesions on scans taken within 12 months of the onset of DAA therapy are more likely to go on to develop HCC.…”

Section: Discussionmentioning

confidence: 99%

“…All local imaging and multidisciplinary team (MDT) reports were collected centrally by the study team for the year prior to therapy and following therapy up until the study endpoint. Tumour size measurements were taken from radiological reports and Barcelona clinic liver cancer (BCLC) scores, Liver Reporting & Data System (Li‐RADS) grading, Milan criteria and response evaluation criteria in solid tumours (RECIST) criteria were applied and appropriate scores/grades generated by the study team. RECIST criteria, which take into account the size and progression of the primary lesion, secondary lesions, nodal, vascular and metastatic disease to give an overall definition for complete resolution, partial resolution, stable or progressive disease, were used to assess tumour progression with the date of cross‐sectional imaging being used to define the observation period.…”

Section: Methodsmentioning

confidence: 99%

The association between hepatocellular carcinoma and direct‐acting anti‐viral treatment in patients with decompensated cirrhosis

Mecci

Kemos

Leen

et al. 2019

Aliment Pharmacol Ther

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Background: Direct-acting anti-viral therapy (DAA) has transformed hepatitis C virus (HCV) care, particularly in patients with decompensated cirrhosis. However, their impact on hepatocellular carcinoma (HCC) remains unclear. Aim: To use a national registry of patients with advanced liver disease to explore the relationship between DAA therapy and HCC. Methods: All patients with de novo HCC post DAA therapy were frequency matched with patients who did not develop HCC. Demographic, clinical and laboratory data were obtained. Cross-sectional imaging and multidisciplinary team reports were reviewed for dates of HCC diagnosis and HCC progression. Patients were categorised by treatment outcome and time of HCC development. Data were examined by multivariable analysis and Kaplan-Meier estimation. Results: Eighty patients with HCC were compared with 165 patients without HCC, treated between June 2014 and September 2015. Mean follow-up from start of DAA therapy was 32.4 months. Twenty-eight patients were diagnosed with early HCC (within 6 months of therapy) and 52 presented late. Baseline nonmalignant lesions (HR: 1.99), thrombocytopaenia (HR: 1.59) and diabetes (HR: 1.68) increased likelihood of HCC. Response to therapy was reduced in patients who developed liver cancer (SVR in patients with HCC = 54/80 (68%), SVR in patients without HCC = 143/165(87%), P < 0.001, OR: 3.13, 95% CI: 1.64-5.99). We found no difference between tumour size, progression or survival between viraemic and nonviraemic patients. Conclusion:There is no alteration in prognosis or cancer progression following HCC development after HCV treatment. However, baseline nonmalignant liver lesions, diabetes and thrombocytopaenia increase the risk of HCC, and HCC is associated with a decreased SVR rate. | 205MECCI Et al.

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“…Ancillary features also can be used to improve lesion detection or diagnostic confidence. Detailed discussion of ancillary features and tie-breaking rules can be found on the ACR website and in review articles (5,8,29).…”

Section: Ct/mri Techniquementioning

confidence: 99%

Liver Imaging Reporting and Data System (LI-RADS) Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients

et al. 2018

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The Liver Imaging Reporting and Data System (LI-RADS) is composed of four individual algorithms intended to standardize the lexicon, as well as reporting and care, in patients with or at risk for hepatocellular carcinoma in the context of surveillance with US; diagnosis with CT, MRI, or contrast material-enhanced US; and assessment of treatment response with CT or MRI. This report provides a broad overview of LI-RADS, including its historic development, relationship to other imaging guidelines, composition, aims, and future directions. In addition, readers will understand the motivation for and key components of the 2018 update.

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LI‐RADS 2017: An update

Abstract: 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;47:1459-1474.

Cited by 37 publications

References 47 publications

⁶⁸Ga-Labeled Prostate-Specific Membrane Antigen Is a Novel PET/CT Tracer for Imaging of Hepatocellular Carcinoma: A Prospective Pilot Study

⁶⁸Ga-Labeled Prostate-Specific Membrane Antigen Is a Novel PET/CT Tracer for Imaging of Hepatocellular Carcinoma: A Prospective Pilot Study

The association between hepatocellular carcinoma and direct‐acting anti‐viral treatment in patients with decompensated cirrhosis

Liver Imaging Reporting and Data System (LI-RADS) Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients

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LI‐RADS 2017: An update

Abstract: 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;47:1459-1474.

Cited by 37 publications

References 47 publications

68Ga-Labeled Prostate-Specific Membrane Antigen Is a Novel PET/CT Tracer for Imaging of Hepatocellular Carcinoma: A Prospective Pilot Study

68Ga-Labeled Prostate-Specific Membrane Antigen Is a Novel PET/CT Tracer for Imaging of Hepatocellular Carcinoma: A Prospective Pilot Study

The association between hepatocellular carcinoma and direct‐acting anti‐viral treatment in patients with decompensated cirrhosis

Liver Imaging Reporting and Data System (LI-RADS) Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients

Contact Info

Product

Resources

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⁶⁸Ga-Labeled Prostate-Specific Membrane Antigen Is a Novel PET/CT Tracer for Imaging of Hepatocellular Carcinoma: A Prospective Pilot Study

⁶⁸Ga-Labeled Prostate-Specific Membrane Antigen Is a Novel PET/CT Tracer for Imaging of Hepatocellular Carcinoma: A Prospective Pilot Study