RSNA 2016

Abstract Archives of the RSNA, 2016


GI349-SD-SUB1

The Utility of LI-RADS v2014 to Characterize the Nodules Detected during Hepatocarcinogenesis in HBV-related Liver Cirrhosis: A Comparative Study of MR Imaging and Pathology

Sunday, Nov. 27 1:00PM - 1:30PM Room: GI Community, Learning Center Station #1



Zhang Qi, Beijing, China (Presenter) Nothing to Disclose
Hongjun Li, Beijing, China (Abstract Co-Author) Nothing to Disclose
PURPOSE

To study the correlationship between the Liver Imaging and Reporting Data System（LI-RADS）v2014 with magnetic resonance（MR)imaging and hisological grade of nodules in HBV-related liver cirrhosis.

METHOD AND MATERIALS

Between Decemember 2012 to February 2016, 178 patients with HBV-related liver cirrhosis who had nodules 30mm or smaller detected at MRI were included and all patients provided written informed consent before the study . A LI-RADS category was retrospectively assigned to each nodule on MRI. Final diagnosis was assessed using pathologic diagnosis only (operation or biopsy). We calculate the percentage of the nodules in each LI-RADS category,and analyze with the Chi-square test(P<0.001).The diagnostic accuracy for each LI-RADS category was described by sensitivity, specificity, and positive and negative predictive values .

RESULTS

we finally analyzed 192 nodules ,8 regenerative nodules(RNs),16 low grade dysplastic nodules(LGDNs),30 high grade dysplastic nodules(HGDNs),35 early HCCs(eHCCs）,103 progressed HCCs（pHCCs).None (0%) of five LI-RADS category 1 lesions,1(9.9%)nodules had a LR-2 assement,consisting of 7 (36.8%)RNs and 12(63.2%)LGDNs;23(12%),a LR-3 assement,consisting of 1(4.3%) RNs,4 (17.4%)LGDNs,12(52.2%)HGDNs,4 (17.4%) eHCCs and 2(8.7%) pHCCs;62（32.3%）a LR-4 assement，including 16(25.8%) HGDNs，25( 40.3%)eHCCs and 21 (33.9%)pHCCs;88（45.8%）a LR-5 assement，including 2(,2.3%) HGDNs，6（6.7%) eHCCs and 80(90.9%) pHCCs(P<0.001).PPV,sensitivity of HCC diagnosis for LR-5 were higher than that for LR-4(97.7%,65.2% VS 74.2%,34.8%).PPV,sensitivity of LR-3 for HCC+HGDN diagnosis were higher than that for HCC diagnosis only（78.3%,11%vs 26.1%,4.9%）.

CONCLUSION

There is no dirrect correlationship between the LI-RADS with magnetic resonance（MR)imaging and hisological grade of nodules in HBV-related liver cirrhosis,whereas LR-5 criteria had excellent PPV for diagnosing HCC, LR-4 and LR-3 criteria were useful in estimating the probability of malignancy.

CLINICAL RELEVANCE/APPLICATION

LI-RADS is recommended for patients with liver cirrhosis to assess the likelihood of malignancy for MR imaging detected nodules.In particular, a relevant proportion of HGDNs (known as the precancerous lesions ) were categorized as LI-RADS category 3 or 4 ,LI-RADS may help to determin the correct diagnostic workup during further clinical practice.