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Open Access Publications from the University of California

Liver Imaging Reporting and Data System (LI-RADS) v2018: Impact on Categorization and Hepatocellular Carcinoma Staging.

  • Author(s): Chernyak, Victoria
  • Flusberg, Milana
  • Berman, Jesse
  • Fruitman, Kate C
  • Kobi, Mariya
  • Fowler, Kathryn J
  • Sirlin, Claude B
  • et al.

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PURPOSE:To assess concordance in categorization and radiologic T staging using Liver Imaging Reporting and Data System (LI-RADS) v2017, LI-RADS v2018, and the Organ Procurement and Transplantation Network (OPTN) criteria. MATERIALS AND METHODS:All MR and CT reports using a standardized LI-RADS macro between 4/15-3/18 were identified retrospectively. Major features (size, arterial phase hyperenhancement [APHE], "washout,", enhancing "capsule", threshold growth) were extracted from the report for each LR-3, LR-4 and LR-5 observation. Each observation was assigned a new category based on LI-RADS v2017, v2018 and OPTN criteria. Radiologic T-stage was calculated based on size and number of LR-5 or OPTN-5 observations. Categories and T stages assigned by each system were compared descriptively. RESULTS:398 patients (67% male, mean age 63.4 years) with 641 observations (median size 14 mm) were included. 73/182 (40.1%) observations categorized LR-4 by LI-RADS v2017 were up-categorized to LR-5 by LI-RADS v2018 due to change in LR-5 criteria. 4/196 (2.0%) observations categorized LR-5 by LI-RADS v2017 were down-categorized to LR-4 by LI-RADS v2018 due to change in threshold growth definition. T stage was higher by LI-RADS v2018 than LI-RADS v2017 in 49/398 (12.3%) patients. Compared to OPTN stage, 12/398 (3.0%) patients were upstaged by LI-RADS v2017 and 60/398 (15.1%) by LI-RADS v2018. 5/101 (5.0%) patients with T2 stage based on LI-RADS v2017 and 10/102 (9.8%) patients with T2 stage based on LI-RADS v2018 did not meet T2 criteria based on OPTN criteria. Of the 98 patients with a T2 stage based on OPTN criteria, two (2.0%) had a stage T ≥ 3 based on LI-RADS v2017 and six (6.1%) had a stage T ≥ 3 based on LI-RADS v2018. CONCLUSION:LI-RADS v2018 increased the number of LR-5 observations by 40.1%, the radiologic T stage in 12.3% of patients, and overall discordance with OPTN T stage. This article is protected by copyright. All rights reserved.

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