Expanding the Liver Imaging Reporting and Data System (LI-RADS) v2018 diagnostic population: performance and reliability of LI-RADS for distinguishing hepatocellular carcinoma (HCC) from non-HCC primary liver carcinoma in patients who do not meet strict LI-RADS high-risk criteria

Daniel R. Ludwig*, Tyler J. Fraum, Roberto Cannella, Richard Tsai, Muhammad Naeem, Maverick LeBlanc, Amber Salter, Allan Tsung, Jaquelyn Fleckenstein, Anup S. Shetty, Amir A. Borhani, Alessandro Furlan, Kathryn J. Fowler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Hepatocellular carcinoma (HCC) can be diagnosed using imaging criteria in patients at high-risk for HCC, according to Liver Imaging Reporting and Data System (LI-RADS) guidelines. The aim of this study was to determine the diagnostic performance and inter-rater reliability (IRR) of LI-RADS v2018 for differentiating HCC from non-HCC primary liver carcinoma (PLC), in patients who are at increased risk for HCC but not included in the LI-RADS ‘high-risk’ population. Methods: This retrospective HIPAA-compliant study included a 10-year experience of pathologically-proven PLC at two liver transplant centers, and included patients with non-cirrhotic hepatitis C infection, non-cirrhotic non-alcoholic fatty liver disease, and fibrosis. Two readers evaluated each lesion and assigned an overall LI-RADS diagnostic category, additionally scoring all major, LR-M, and ancillary features. Results: The final study cohort consisted of 27 HCCs and 104 non-HCC PLC in 131 patients. The specificity of a ‘definite HCC’ designation was 97% for reader 1 and 100% for reader 2. The IRR was fair for overall LI-RADS category and substantial for most major features. Conclusion: In a population at increased risk for HCC but not currently included in the LI-RADS ‘high-risk’ population, LI-RADS v2018 demonstrated very high specificity for distinguishing pathologically-proven HCC from non-HCC PLC.

Original languageEnglish (US)
Pages (from-to)1697-1706
Number of pages10
JournalHPB
Volume21
Issue number12
DOIs
StatePublished - Dec 2019
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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