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Effect of threshold growth as a major feature on LI-RADS categorization

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Abstract

Purpose

Liver Imaging Reporting and Data System (LI-RADS) uses major features (arterial phase hyperenhancement [APHE], “washout” [WO], “capsule,” diameter, threshold growth [TG]) to codify probability of hepatocellular carcinoma for each observation. This study assessed the effect of removing TG as a major feature on LI-RADS categorization.

Materials and methods

In this HIPAA-compliant, IRB-approved study, all MR and CT clinical reports containing a standardized LI-RADS v2014 template between 4/15–1/17 were retrospectively reviewed for each LR-3, LR-4, and LR-5 reported observation. Two LI-RADS categories were then assigned: one using all LI-RADS major features and one after removing TG as a major feature. The two categories were compared descriptively.

Results

The study included 265 patients (172 [65%] male, mean age 63 [±10] years) with 489 observations (median diameter 14 mm, IQR 10–20 mm), of which 345 (71%) had APHE, 307 (63%) had WO, 86 (18%) had “capsule,” and 72 (15%) had TG. Of 86 observations with TG, 47 (65%) were new observations ≥10 mm, 14 (19%) had diameter increase ≥50% in ≤6 months, and 11 (15%) had diameter increase ≥100% in >6 months. Using all major features, 214/489 (44%) observations were LR-3, 129/489 (26%) were LR-4, and 146/489 (30%) were LR-5. After removing TG, 237/489 (48%) were LR-3, 119/489 (24%) were LR-4, and 133 (27%) were LR-5. Removing TG caused a category downgrade for 35/489 (7%, 95% CI 5–10) observations, including 13/146 (9%, 95% CI 3–14) LR-5 observations.

Conclusion

9% of LR-5 observations would be downgraded without TG.

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Authors and Affiliations

  1. Department of Radiology, Montefiore Medical Center, Bronx, USA

    Victoria Chernyak, Mariya Kobi, Milana Flusberg & Kate C. Fruitman

  2. The Liver Imaging Group, Department of Radiology, University of California, San Diego, La Jolla, USA

    Claude B. Sirlin

Authors
  1. Victoria Chernyak
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  2. Mariya Kobi
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  3. Milana Flusberg
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  4. Kate C. Fruitman
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  5. Claude B. Sirlin
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Corresponding author

Correspondence to Victoria Chernyak.

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Funding

No funding was received for this study.

Conflict of interest

V. Chernyak, M. Kobi, M. Flusberg, K.C. Fruitman have no conflict of interest. C.B. Sirlin: Industry grant support—Siemens, GE, Guerbet; Consulting and service agreements—Bracco, Alexion, AstraZeneca, Bioclinica, BMS, Fibrogen, Galmed, Genentech, Genzyme, Gilead, Icon, Intercept, Isis, Janssen, NuSirt, Perspectum, Pfizer, Profil, Sanofi, Shire, Synageva, Tobira, Takeda, Virtual Scopics

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The requirement for the informed consent was waived by the Institutional Review Board.

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Chernyak, V., Kobi, M., Flusberg, M. et al. Effect of threshold growth as a major feature on LI-RADS categorization. Abdom Radiol 42, 2089–2100 (2017). https://doi.org/10.1007/s00261-017-1105-8

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  • DOI: https://doi.org/10.1007/s00261-017-1105-8

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