Top

Current Hepatology Reports

Published in:

01-12-2020 | Hepatocellular Carcinoma | Hepatic Cancer (N Parikh, Section Editor)

LI-RADS Imaging Criteria for HCC Diagnosis and Treatment: Emerging Evidence

Authors: Anum Aslam, Richard Kinh Gian Do, Victoria Chernyak, Mishal Mendiratta-Lala

Published in: Current Hepatology Reports | Issue 4/2020

Abstract

Purpose of Review

The purpose of this study is to review the recent literature analyzing the performance of Liver Imaging Reporting and Data System (LI-RADS) v2018 diagnostic and treatment response algorithm (TRA) for initial diagnosis and assessment of hepatocellular carcinoma (HCC) following locoregional therapy (LRT).

Recent Findings

LI-RADS is a comprehensive tool for assessment and reporting of observations in patients at risk of developing HCC. Since HCC is predominantly an imaging diagnosis, it is important to achieve a high sensitivity and specificity for each LR category. Therefore, a multitude of studies have been published over the recent years illustrating the diagnostic yield of both the diagnostic and treatment response algorithms. In addition, the role of abbreviated MRI for screening has also been studied recently.

Summary

LI-RADS diagnostic algorithm has been validated by a number of recent studies that have provided a high diagnostic reliability for categorizing each observation, when using major as well as combination of major and ancillary features. In addition, LI-RADS TRA is being validated by the emerging literature providing promising results for treatment of HCC following ablation and nonradiation-based arterial therapies. However, further insight and in depth research is required to validate the imaging appearance of radiation-based therapies as well as utilization of ancillary features for response assessment after locoregional therapy.

Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2018;68(2):723–50. https://doi.org/10.1002/hep.29913.CrossRefPubMed

Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358–80. https://doi.org/10.1002/hep.29086.CrossRefPubMed

Rich NE, Parikh ND, Singal AG. Overdiagnosis: An understudied issue in hepatocellular carcinoma surveillance. Semin Liver Dis. 2017;37(4):296-304. Epub 2017/12/22. https://doi.org/10.1055/s-0037-1608775.

• Elsayes KM, Kielar AZ, Chernyak V, Morshid A, Furlan A, Masch WR, et al. LI-RADS: a conceptual and historical review from its beginning to its recent integration into AASLD clinical practice guidance. J Hepatocell Carcinoma. 2019;6:49-69. Epub 2019/02/05. https://doi.org/10.2147/JHC.S186239. This article provides an important review of major LI-RADS updates since its inception in 2011 and also discusses the currently published LI-RADS algorithms.

•• American College of Radiology 2018 Liver Imaging Reporting and Data Systems Version 2018 Manual. 2018. ACR LI-RADS manual is an extremely important document that provides standardized reporting of HCC on CT/MR in at risk population and has been integrated into the American Association for the study of liver diseases (AASLD) 2018 hepatocellular carcinoma clinical practice guideline.

Corwin MT, Lee AY, Fananapazir G, Loehfelm TW, Sarkar S, Sirlin CB. Nonstandardized terminology to describe focal liver lesions in patients at risk for hepatocellular carcinoma: implications regarding clinical communication. AJR Am J Roentgenol. 2018;210(1):85–90. Epub 2017/10/12. https://doi.org/10.2214/AJR.17.18416.CrossRefPubMed

Flusberg M, Ganeles J, Ekinci T, Goldberg-Stein S, Paroder V, Kobi M, et al. Impact of a structured report template on the quality of CT and MRI reports for hepatocellular carcinoma diagnosis. J Am Coll Radiol. 2017;14(9):1206–11. Epub 2017/05/06. https://doi.org/10.1016/j.jacr.2017.02.050.CrossRefPubMed

Goldberg-Stein S, Chernyak V. Adding value in radiology reporting. J Am Coll Radiol. 2019;16(9 Pt B):1292–8. https://doi.org/10.1016/j.jacr.2019.05.042.CrossRefPubMed

Chernyak V, Fowler KJ, Kamaya A, Kielar AZ, Elsayes KM, Bashir MR, et al. Liver Imaging Reporting and Data System (LI-RADS) version 2018: Imaging of hepatocellular carcinoma in at-risk patients. Radiology. 2018;289(3):816–30. Epub 2018/09/25. https://doi.org/10.1148/radiol.2018181494.CrossRefPubMed

10.

Tang A, Hallouch O, Chernyak V, Kamaya A, Sirlin CB. Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis. Abdom Radiol (NY). 2018;43(1):13–25. https://doi.org/10.1007/s00261-017-1209-1.CrossRefPubMed

11.

•• van der Pol CB, Lim CS, Sirlin CB, McGrath TA, Salameh JP, Bashir MR, et al. Accuracy of the liver imaging reporting and data system in computed tomography and magnetic resonance image analysis of hepatocellular carcinoma or overall malignancy-a systematic review. Gastroenterology. 2019;156(4):976-986. Epub 2018/11/13. https://doi.org/10.1053/j.gastro.2018.11.020. Large systemic analysis that demonstrates the percentage of HCC and other malignancy in each LI-RADS category.

12.

Tang A, Bashir MR, Corwin MT, Cruite I, Dietrich CF, Do RKG, et al. Evidence supporting LI-RADS major features for CT- and MR imaging-based diagnosis of hepatocellular carcinoma: a systematic review. Radiology. 2018;286(1):29–48. Epub 2017/11/21. https://doi.org/10.1148/radiol.2017170554.CrossRefPubMed

13.

Tang A, Singal AG, Mitchell DG, Hecht EM, Fowler KJ, Kulik L, et al. Introduction to the liver imaging reporting and data system for hepatocellular carcinoma. Clin Gastroenterol Hepatol. 2019;17(7):1228–38. Epub 2018/10/13. https://doi.org/10.1016/j.cgh.2018.10.014.CrossRefPubMed

14.

Fowler KJ, Potretzke TA, Hope TA, Costa EA, Wilson SR. LI-RADS M (LR-M): definite or probable malignancy, not specific for hepatocellular carcinoma. Abdom Radiol (NY). 2018;43(1):149–57. https://doi.org/10.1007/s00261-017-1196-2.CrossRefPubMed

15.

Santillan C, Chernyak V, Sirlin C. LI-RADS categories: concepts, definitions, and criteria. Abdom Radiol (NY). 2018;43(1):101–10. https://doi.org/10.1007/s00261-017-1334-x.CrossRefPubMed

16.

Thölking G, Schuette-Nuetgen K, Kentrup D, Pawelski H, Reuter S. Imaging-based diagnosis of acute renal allograft rejection. World J Transplant. 2016;6(1):174–82. https://doi.org/10.5500/wjt.v6.i1.174.CrossRefPubMedPubMedCentral

17.

Furlan A. New Progress toward Validation of LI-RADS Version 2018. Radiology. 2019;291(1):81–2. Epub 2019/01/29. https://doi.org/10.1148/radiol.2019182890.CrossRefPubMed

18.

• Ren AH, Zhao PF, Yang DW, Du JB, Wang ZC, Yang ZH. Diagnostic performance of MR for hepatocellular carcinoma based on LI-RADS v2018, compared with v2017. J Magn Reson Imaging. 2019;50(3):746-755. Epub 2019/01/15. https://doi.org/10.1002/jmri.26640. This is an important study comparing the diagnostic performance of LI-RADS v2018 and 2017 with greater sensitivity, negative predictive value and accuracy of v2018 especially when adopting LR-5 as a predictor of HCC.

19.

Lee SM, Lee JM, Ahn SJ, Kang HJ, Yang HK, Yoon JH. LI-RADS version 2017 versus version 2018: diagnosis of hepatocellular carcinoma on gadoxetate disodium-enhanced MRI. Radiology. 2019;292(3):655–63. Epub 2019/07/16. https://doi.org/10.1148/radiol.2019182867.CrossRefPubMed

20.

Smereka P, Doshi AM, Lavelle LP, Shanbhogue K. New arterial phase enhancing nodules on MRI of cirrhotic liver: risk of progression to hepatocellular carcinoma and implications for LI-RADS classification. AJR Am J Roentgenol. 2020:1–8. Epub 2020/05/20. https://doi.org/10.2214/AJR.19.22033.

21.

Chernyak V, Flusberg M, Berman J, Fruitman KC, Kobi M, Fowler KJ, et al. Liver imaging reporting and data system version 2018: impact on categorization and hepatocellular carcinoma staging. Liver Transpl. 2019;25(10):1488–502. Epub 2019/09/09. https://doi.org/10.1002/lt.25614.CrossRefPubMed

22.

Ko A, Park HJ, Lee ES, Park SB, Kim YK, Choi SY, et al. Comparison of the diagnostic performance of the 2017 and 2018 versions of LI-RADS for hepatocellular carcinoma on gadoxetic acid enhanced MRI. Clin Radiol. 2020;75(4):319.e1-319.e9. Epub 2019/12/16. https://doi.org/10.1016/j.crad.2019.11.004.

23.

Cerny M, Bergeron C, Billiard JS, Murphy-Lavallée J, Olivié D, Bérubé J, et al. LI-RADS for MR Imaging Diagnosis of Hepatocellular Carcinoma: Performance of Major and Ancillary Features. Radiology. 2018;288(1):118–28. Epub 2018/04/10. https://doi.org/10.1148/radiol.2018171678.CrossRefPubMed

24.

Joo I, Lee JM, Lee DH, Ahn SJ, Lee ES, Han JK. Liver imaging reporting and data system v2014 categorization of hepatocellular carcinoma on gadoxetic acid-enhanced MRI: Comparison with multiphasic multidetector computed tomography. J Magn Reson Imaging. 2017;45(3):731-740. Epub 2016/07/30. https://doi.org/10.1002/jmri.25406.

25.

Ren AH, Du JB, Yang DW, Zhao PF, Wang ZC, Yang ZH. The role of ancillary features for diagnosing hepatocellular carcinoma on CT: based on the Liver Imaging Reporting and Data System version 2017 algorithm. Clin Radiol. 2020;75(6):478.e25–35. Epub 2020/02/20. https://doi.org/10.1016/j.crad.2019.08.031.CrossRef

26.

Fowler KJ, Tang A, Santillan C, Bhargavan-Chatfield M, Heiken J, Jha RC, et al. Interreader reliability of LI-RADS version 2014 algorithm and imaging features for diagnosis of hepatocellular carcinoma: A large international multireader study. Radiology. 2018;286(1):173–85. Epub 2017/11/01. https://doi.org/10.1148/radiol.2017170376.CrossRefPubMed

27.

Ludwig DR, Fraum TJ, Cannella R, Ballard DH, Tsai R, Naeem M, et al. Hepatocellular carcinoma (HCC) versus non-HCC: accuracy and reliability of Liver Imaging Reporting and Data System v2018. Abdom Radiol (NY). 2019;44(6):2116–32. https://doi.org/10.1007/s00261-019-01948-x.CrossRefPubMedPubMedCentral

28.

• Abdel Razek AAK, El-Serougy LG, Saleh GA, Abd El-Wahab R, Shabana W. Interobserver agreement of magnetic resonance imaging of liver imaging reporting and data system version 2018. J Comput Assist Tomogr. 2020;44(1):118–23. https://doi.org/10.1097/RCT.0000000000000945A retrospective analysis showing excellent agreement in LR-5 and LR-M categories on MRI with LI-RADS v2018.

29.

Stocker D, Becker AS, Barth BK, Skawran S, Kaniewska M, Fischer MA, et al. Does quantitative assessment of arterial phase hyperenhancement and washout improve LI-RADS v2018-based classification of liver lesions?. Eur Radiol. 2020. Epub 2020/02/04. https://doi.org/10.1007/s00330-019-06596-9.

30.

Choi D, Mitchell DG, Verma SK, Bergin D, Navarro VJ, Malliah AB, et al. Hepatocellular carcinoma with indeterminate or false-negative findings at initial MR imaging: effect on eligibility for curative treatment initial observations. Radiology. 2007;244(3):776-783. Epub 2007/08/09. https://doi.org/10.1148/radiol.2443061355.

31.

Holland AE, Hecht EM, Hahn WY, Kim DC, Babb JS, Lee VS, et al. Importance of small (< or = 20-mm) enhancing lesions seen only during the hepatic arterial phase at MR imaging of the cirrhotic liver: evaluation and comparison with whole explanted liver. Radiology. 2005;237(3):938–44. https://doi.org/10.1148/radiol.2373041364.CrossRefPubMed

32.

Choi JY, Cho HC, Sun M, Kim HC, Sirlin CB. Indeterminate observations (liver imaging reporting and data system category 3) on MRI in the cirrhotic liver: fate and clinical implications. AJR Am J Roentgenol. 2013;201(5):993–1001. https://doi.org/10.2214/AJR.12.10007.CrossRefPubMed

33.

Shropshire E, Mamidipalli A, Wolfson T, Allen BC, Jaffe TA, Igarashi S, et al. LI-RADS ancillary feature prediction of longitudinal category changes in LR-3 observations: an exploratory study. Abdom Radiol (NY). 2020. Epub 2020/02/12. https://doi.org/10.1007/s00261-020-02429-2.

34.

Kim DH, Choi SH, Park SH, Kim KW, Byun JH, Kim SY, et al. Liver imaging reporting and data system category M: A systematic review and meta-analysis. Liver Int. 2020;40(6):1477-1487. Epub 2020/03/15. https://doi.org/10.1111/liv.14420.

35.

• Kim YY, Kim MJ, Kim EH, Roh YH, An C. Hepatocellular carcinoma versus other hepatic malignancy in cirrhosis: performance of LI-RADS version 2018. Radiology. 2019;291(1):72-80. Epub 2019/01/29. https://doi.org/10.1148/radiol.2019181995. LR-5 and LR-M in LI-RADS v2018 can effectively differentiate HCC from other malignancy in patients with liver cirrhosis.

36.

Park HJ, Kim YK, Cha DI, Ko SE, Kim S, Lee ES, et al. Targetoid hepatic observations on gadoxetic acid-enhanced MRI using LI-RADS version 2018: emphasis on hepatocellular carcinomas assigned to the LR-M category. Clin Radiol. 2020. Epub 2020/02/05. https://doi.org/10.1016/j.crad.2020.01.002.

37.

Kim MY, Joo I, Kang HJ, Bae JS, Jeon SK, Lee JM. LI-RADS M (LR-M) criteria and reporting algorithm of v2018: diagnostic values in the assessment of primary liver cancers on gadoxetic acid-enhanced MRI. Abdom Radiol (NY). 2020. Epub 2020/05/07. https://doi.org/10.1007/s00261-020-02545-z.

38.

Chan MV, McDonald SJ, Ong YY, Mastrocostas K, Ho E, Huo YR, et al. HCC screening: assessment of an abbreviated non-contrast MRI protocol. Eur Radiol Exp. 2019;3(1):49. Epub 2019/12/18. https://doi.org/10.1186/s41747-019-0126-1.

39.

Roberts LR, Sirlin CB, Zaiem F, Almasri J, Prokop LJ, Heimbach JK, et al. Imaging for the diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis. Hepatology. 2018;67(1):401-421. Epub 2017/11/29. https://doi.org/10.1002/hep.29487.

40.

Hanna RF, Miloushev VZ, Tang A, Finklestone LA, Brejt SZ, Sandhu RS, et al. Comparative 13-year meta-analysis of the sensitivity and positive predictive value of ultrasound, CT, and MRI for detecting hepatocellular carcinoma. Abdom Radiol (NY). 2016;41(1):71–90. https://doi.org/10.1007/s00261-015-0592-8.CrossRefPubMed

41.

• Khatri G, Pedrosa I, Ananthakrishnan L, de Leon AD, Fetzer DT, Leyendecker J, et al. Abbreviated-protocol screening MRI vs. complete-protocol diagnostic MRI for detection of hepatocellular carcinoma in patients with cirrhosis: An equivalence study using LI-RADS v2018. J Magn Reson Imaging. 2020;51(2):415-425. https://doi.org/10.1002/jmri.26835. An important study indicating abbreviated MRI is comparable and equivalent to complete diagnostic MRI for HCC detection in cirrhotic patients.

42.

Brunsing RL, Chen DH, Schlein A, Wolfson T, Gamst A, Mamidipalli A, et al. Gadoxetate-enhanced abbreviated MRI for hepatocellular carcinoma surveillance: preliminary experience. Radiology: Imaging Cancer. 2019;1:2.

43.

Sawrie SM, Fiveash JB, Caudell JJ. Stereotactic body radiation therapy for liver metastases and primary hepatocellular carcinoma: normal tissue tolerances and toxicity. Cancer Control. 2010;17(2):111–9. https://doi.org/10.1177/107327481001700206.CrossRefPubMed

44.

•• Kielar A, Fowler KJ, Lewis S, Yaghmai V, Miller FH, Yarmohammadi H, et al. Locoregional therapies for hepatocellular carcinoma and the new LI-RADS treatment response algorithm. Abdom Radiol (NY). 2018;43(1):218–30. https://doi.org/10.1007/s00261-017-1281-6An important review article providing insight into the mechanism of different liver-directed therapies, illustrate the typical expected imaging appearance of HCC on CT and MRI after locoregional therapy and discuss the LI-RADS treatment response algorithm.CrossRef

45.

Narsinh KH, Duncan DP, Newton IG, Minocha J, Rose SC. Liver-directed therapy for hepatocellular carcinoma. Abdom Radiol (NY). 2018;43(1):203–17. https://doi.org/10.1007/s00261-017-1435-6.CrossRefPubMed

46.

Inchingolo R, Posa A, Mariappan M, Spiliopoulos S. Locoregional treatments for hepatocellular carcinoma: Current evidence and future directions. World J Gastroenterol. 2019;25(32):4614–28. https://doi.org/10.3748/wjg.v25.i32.4614.CrossRefPubMedPubMedCentral

47.

Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology. 2003;37(2):429–42. https://doi.org/10.1053/jhep.2003.50047.CrossRefPubMed

48.

Marelli L, Stigliano R, Triantos C, Senzolo M, Cholongitas E, Davies N, et al. Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol. 2007;30(1):6–25. https://doi.org/10.1007/s00270-006-0062-3.CrossRefPubMed

49.

Meyer T, Kirkwood A, Roughton M, Beare S, Tsochatzis E, Yu D, et al. A randomised phase II/III trial of 3-weekly cisplatin-based sequential transarterial chemoembolisation vs embolisation alone for hepatocellular carcinoma. Br J Cancer. 2013;108(6):1252-1259. Epub 2013/02/28. https://doi.org/10.1038/bjc.2013.85.

50.

Molla N, AlMenieir N, Simoneau E, Aljiffry M, Valenti D, Metrakos P, et al. The role of interventional radiology in the management of hepatocellular carcinoma. Curr Oncol. 2014;21(3):e480–92. https://doi.org/10.3747/co.21.1829.CrossRefPubMedPubMedCentral

51.

Heckman JT, Devera MB, Marsh JW, Fontes P, Amesur NB, Holloway SE, et al. Bridging locoregional therapy for hepatocellular carcinoma prior to liver transplantation. Ann Surg Oncol. 2008;15(11):3169–77. Epub 2008/08/12. https://doi.org/10.1245/s10434-008-0071-3.CrossRefPubMed

52.

Gamblin TC, Geller DA. Downstaging hepatocellular carcinoma prior to liver transplantation. Liver Transpl. 2005;11(12):1466–8. https://doi.org/10.1002/lt.20528.CrossRefPubMed

53.

Mora RA, Ali R, Gabr A, Abouchaleh N, Asadi AA, Kallini JR, et al. Pictorial essay: imaging findings following Y90 radiation segmentectomy for hepatocellular carcinoma. Abdom Radiol (NY). 2018;43(7):1723–38. https://doi.org/10.1007/s00261-017-1391-1.CrossRefPubMed

54.

Galun D, Basaric D, Zuvela M, Bulajic P, Bogdanovic A, Bidzic N, et al. Hepatocellular carcinoma: From clinical practice to evidence-based treatment protocols. World J Hepatol. 2015;7(20):2274–91. https://doi.org/10.4254/wjh.v7.i20.2274.CrossRefPubMedPubMedCentral

55.

•• Mendiratta-Lala M, Gu E, Owen D, Cuneo KC, Bazzi L, Lawrence TS, et al. Imaging findings within the first 12 months of hepatocellular carcinoma treated With stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2018;102(4):1063-1069. Epub 2017/08/24. https://doi.org/10.1016/j.ijrobp.2017.08.022. This study correlates the imaging findings of HCC treated with SBRT to explant pathology. This is important since post treatment imaging appearance of HCC following treatment with radiation based therapy is different with persistent APHE that can last upto a year or more when compared to other non-radiation based treatments and does not necessarily mean treatment failure.

56.

Mendiratta-Lala M, Masch W, Shankar PR, Hartman HE, Davenport MS, Schipper MJ, et al. Magnetic resonance imaging evaluation of hepatocellular carcinoma treated with stereotactic body radiation therapy: long term imaging follow-Up. Int J Radiat Oncol Biol Phys. 2019;103(1):169-179. Epub 2018/09/10. https://doi.org/10.1016/j.ijrobp.2018.09.004.

57.

Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol. 2001;35(3):421–30. https://doi.org/10.1016/s0168-8278(01)00130-1.CrossRefPubMed

58.

Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30(1):52-60. Epub 2010/02/19. https://doi.org/10.1055/s-0030-1247132.

59.

Elsayes KM, Hooker JC, Agrons MM, Kielar AZ, Tang A, Fowler KJ, et al. 2017 version of LI-RADS for CT and MR imaging: an update. Radiographics. 2017;37(7):1994–2017. https://doi.org/10.1148/rg.2017170098.CrossRefPubMed

60.

Ebara M, Hatano R, Fukuda H, Yoshikawa M, Sugiura N, Saisho H. Natural course of small hepatocellular carcinoma with underlying cirrhosis. A study of 30 patients. Hepatogastroenterology. 1998(45 Suppl 3):1214–20.

61.

Kubota K, Ina H, Okada Y, Irie T. Growth rate of primary single hepatocellular carcinoma: determining optimal screening interval with contrast enhanced computed tomography. Dig Dis Sci. 2003;48(3):581–6. https://doi.org/10.1023/a:1022505203786.CrossRefPubMed

62.

An C, Choi YA, Choi D, Paik YH, Ahn SH, Kim MJ, et al. Growth rate of early-stage hepatocellular carcinoma in patients with chronic liver disease. Clin Mol Hepatol. 2015;21(3):279-286. Epub 2015/09/30. https://doi.org/10.3350/cmh.2015.21.3.279.

63.

Seo N, Kim MS, Park MS, Choi JY, Do RKG, Han K, et al. Evaluation of treatment response in hepatocellular carcinoma in the explanted liver with Liver Imaging Reporting and Data System version 2017. Eur Radiol. 2020;30(1):261–71.

64.

Chaudhry M, McGinty KA, Mervak B, Lerebours R, Li C, Shropshire E, et al. The LI-RADS version 2018 mri treatment response algorithm: evaluation of ablated hepatocellular carcinoma. Radiology. 2020;294(2):320-326. Epub 2019/12/17. https://doi.org/10.1148/radiol.2019191581.

65.

Shropshire EL, Chaudhry M, Miller CM, Allen BC, Bozdogan E, Cardona DM, et al. LI-RADS treatment response algorithm: performance and diagnostic accuracy. Radiology. 2019;292(1):226-234. Epub 2019/04/30. https://doi.org/10.1148/radiol.2019182135.

66.

Cools KS, Moon AM, Burke LMB, McGinty KA, Strassle PD, Gerber DA. Validation of the liver imaging reporting and data system treatment response criteria after thermal ablation for hepatocellular carcinoma. Liver Transpl. 2020;26(2):203–14. Epub 2019/12/20. https://doi.org/10.1002/lt.25673.CrossRefPubMed

67.

Abdel Razek AAK, El-Serougy LG, Saleh GA, Shabana W, Abd El-Wahab R. Reproducibility of LI-RADS treatment response algorithm for hepatocellular carcinoma after locoregional therapy. Diagn Interv Imaging. 2020. Epub 2020/04/03. https://doi.org/10.1016/j.diii.2020.03.008.

68.

• Park S, Joo I, Lee DH, Bae JS, Yoo J, Kim SW, et al. Diagnostic performance of LI-RADS treatment response algorithm for hepatocellular carcinoma: adding ancillary features to MRI compared with enhancement patterns at CT and MRI. Radiology. 2020:192797. Epub 2020/07/21. https://doi.org/10.1148/radiol.2020192797. Recently published article discussing the importance of incorporating ancillary features to the LI-RADS treatment response algorithm in prediction of pathologic tumor viability in patients with HCC treated with loco-regional therapy.

69.

Kim SW, Joo I, Kim HC, Ahn SJ, Kang HJ, Jeon SK, et al. LI-RADS treatment response categorization on gadoxetic acid-enhanced MRI: diagnostic performance compared to mRECIST and added value of ancillary features. Eur Radiol. 2020;30(5):2861-2870. Epub 2020/01/31. https://doi.org/10.1007/s00330-019-06623-9.

70.

Riaz A, Kulik L, Lewandowski RJ, Ryu RK, Giakoumis Spear G, Mulcahy MF, et al. Radiologic-pathologic correlation of hepatocellular carcinoma treated with internal radiation using yttrium-90 microspheres. Hepatology. 2009;49(4):1185–93. https://doi.org/10.1002/hep.22747.CrossRefPubMed

71.

Vouche M, Kulik L, Atassi R, Memon K, Hickey R, Ganger D, et al. Radiological-pathological analysis of WHO, RECIST, EASL, mRECIST and DWI: Imaging analysis from a prospective randomized trial of Y90 ± sorafenib. Hepatology. 2013;58(5):1655–66. Epub 2013/10/01. https://doi.org/10.1002/hep.26487.CrossRefPubMed

Title: LI-RADS Imaging Criteria for HCC Diagnosis and Treatment: Emerging Evidence
Authors: Anum Aslam
Richard Kinh Gian Do
Victoria Chernyak
Mishal Mendiratta-Lala
Publication date: 01-12-2020
Publisher: Springer US
Keywords: Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: Current Hepatology Reports / Issue 4/2020
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-020-00546-6

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 4/2020

High-Risk Groups for Non-alcoholic Fatty Liver and Non-alcoholic Steatohepatitis Development and Progression

Diagnosis and Management of Occult Hepatitis B Infection

The Role of Gut Microbiome-Targeted Therapy in Nonalcoholic Fatty Liver Disease

Spontaneous Bacterial Peritonitis and Secondary Bacterial Peritonitis—a Comprehensive Review

National and Global Ethnicity Differences in Non-alcoholic Fatty Liver Disease

Current and Emerging Treatments for Non-alcoholic Steatohepatitis

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage