Stephanie Channual MD, Presenter: Nothing to Disclose

Anokh Pahwa MD, Abstract Co-Author: Nothing to Disclose

James Sayre PhD, Abstract Co-Author: Nothing to Disclose

Katrina Richards Beckett MD, Abstract Co-Author: Nothing to Disclose

David Shin-Kuo Lu MD, Abstract Co-Author: Consultant, Covidien AG Speaker, Covidien AG Consultant, Johnson & Johnson Research Grant, Johnson & Johnson Consultant, Bayer AG Research Grant, Bayer AG Speaker, Bayer AG

Steven Satish Raman MD, Abstract Co-Author: Nothing to Disclose

To determine the performance of LI-RADS for the non- invasive diagnosis of HCC using Gd-EOB-DTPA MRI.

This was an IRB approved, HIPAA compliant study with 84 consecutive suspected HCC nodules in 78 patients confirmed by percutaneous biopsy, resection, or explant within 90 days of Gd-EOB-DTPA MRI (EOB). Nodule size, presence of a capsule, signal intensity on T1-weighted imaging, and enhancement patterns were recorded. The nodules were then categorized as LI-RADS 3, 4, or 5 based on the LI-RADS v2013.1 ACR major criteria.

Of the 84 nodules, 76 were confirmed HCC (90.5%). A total of 15/84 nodules were categorized as LI-RADS 3, 27/84 as LI-RADS 4, and 42/84 as LI-RADS 5. Of these, 11, 25, and 40 nodules were pathologically proven as HCC, respectively (sensitivities 14%, 33%, and 53%, respectively; specificities, 50%, 75%, and 75%, respectively). The PPV of LI-RADS 3, 4, and 5 were 73%, 93%, and 93%, respectively. The NPV of LI-RADS 3, 4, and 5 were 5.8%, 10.5%, and 14.3%, respectively. The accuracy of LI-RADS 4 and LI-RADS 5 combined was 82% (69/84).

Although use of LI-RADS v2013.1 ACR criteria with EOB yields a high PPV and accuracy for diagnosing HCC, moderate sensitivity and specificity suggest that further refinement of the criteria may be necessary and tissue biopsy may be complementary for diagnosis.

LI-RADS standardizes the diagnosis of nodules in cirrhotic livers using MRI with extracellular contrast agents, while its performance using Gd-EOB-DTPA, a hepatocyte-specific contrast, is unknown.

Channual, S, Pahwa, A, Sayre, J, Beckett, K, Lu, D, Raman, S, Performance of LI-RADS Criteria for Diagnosis of Pathologically Proven Hepatocellular Carcinoma (HCC) Using Gd-EOB-DTPA: Can We Use Hepatobiliary Agents and Eliminate Tissue Diagnosis?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044425.html