Tumor in vein (LR-TIV) and liver imaging reporting and data system (LI-RADS) v2018: diagnostic features, pitfalls, prognostic and management implications

Roberta Catania*, Kalina Chupetlovska, Amir A. Borhani, Ekta Maheshwari, Alessandro Furlan

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Vascular invasion by hepatocellular carcinoma (HCC), also known as tumor in vein (TIV), indicates highly invasive tumor behavior and is also associated with poor outcome. Because a diagnosis of TIV precludes liver transplantation, knowledge of the imaging findings to differentiate between TIV and bland thrombus is key for proper patient management. Prior versions of liver imaging reporting and data system (LI-RADS) included presence of TIV as part of LR-5 criteria. However, even if HCC is the most common liver malignancy associated with TIV, other tumors can have vascular invasion and may occur in cirrhotic patients. For these reasons, in LI-RADS v2017 LR-TIV has been introduced as a new different diagnostic category. The aim of this article is to discuss the diagnostic criteria of LR-TIV according to LI-RADS v2018 and analyze potential pitfalls encountered on daily clinical practice. Indeterminate cases and how to manage them will also be discussed.

Original languageEnglish (US)
Pages (from-to)5723-5734
Number of pages12
JournalAbdominal Radiology
Volume46
Issue number12
DOIs
StatePublished - Dec 2021

Keywords

  • CEUS
  • Hepatocellular carcinoma
  • LI-RADS
  • LR-TIV
  • Magnetic resonance imaging
  • Multidetector computed imaging

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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