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

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.

Results of transarterial chemoembolization of hepatocellular carcinoma as a bridging therapy to liver transplantation

“…The mean number of procedures performed in our sample was lower than the 2.5 ± 1.5 reported in the literature (28) . The reported level of interobserver agreement between radiologists for the presence or absence of a Liver Imaging Reporting and Data System (LI-RADS) category 5 lesion was excellent when mRECIST criteria were utilized (29) . In the evaluation of the tumor response after TACE, according to the mRECIST classification, a correlation has been observed between the mRECIST response and total necrosis in the liver explant, nearly 80% of patients with total necrosis in the explant having been found to show a complete response according to the mRECIST classification (19) .…”