LI-RADS: Diagnostic Performance of Hepatobiliary Phase Hypointensity and Major Imaging Features of LR-3 and LR-4 Lesions Measuring 10-19 mm With Arterial Phase Hyperenhancement.

Published

Journal Article

OBJECTIVE. The purpose of this study was to determine the diagnostic performance of hepatobiliary phase hypointensity and Liver Imaging Reporting and Data System (LI-RADS) major imaging features in the diagnosis of hepatocellular carcinoma (HCC) in hepatic lesions with arterial phase hyperenhancement (APHE) measuring 10-19 mm in patients at high risk of HCC. MATERIALS AND METHODS. A composite reference standard of pathologic analysis and imaging follow-up was used. The diagnostic performance (sensitivity and specificity) of hepatobiliary phase hypointensity and LI-RADS major imaging features other than APHE for the diagnosis of HCC was assessed and compared by means of a logistic regression model. RESULTS. This retrospective dual-institution study included 189 LI-RADS LR-3 and LR-4 lesions measuring 10-19 mm and having APHE in 144 consecutively registered patients (96 men, 48 women; mean age, 58 years). Hepatobiliary phase hypointensity had significantly higher sensitivity (84% [92/109], p < 0.00001) than major imaging features in the diagnosis of HCC but lower specificity (84% [67/80]; p = 0.01). However, hepatobiliary phase hypointensity in LR-3 observations measuring 10-19 mm and having APHE had moderately elevated sensitivity (73% [44/60]) and specificity (85%, 64/75). All three major imaging features had high specificity for the diagnosis of HCC, including 95% (76/80) for washout, 100% (80/80) for enhancing capsule, and 99% (79/80) for threshold growth. CONCLUSION. Major imaging features have high specificity for the diagnosis of HCC in lesions measuring 10-19 mm that have APHE. The finding of hepatobiliary phase hypointensity significantly improves sensitivity while moderately high specificity is maintained for the diagnosis of HCC in LR-3 lesions measuring 10-19 mm that exhibit APHE.

Full Text

Duke Authors

Cited Authors

  • Vernuccio, F; Cannella, R; Meyer, M; Choudhoury, KR; Gonzáles, F; Schwartz, FR; Gupta, RT; Bashir, MR; Furlan, A; Marin, D

Published Date

  • August 2019

Published In

Volume / Issue

  • 213 / 2

Start / End Page

  • W57 - W65

PubMed ID

  • 31039012

Pubmed Central ID

  • 31039012

Electronic International Standard Serial Number (EISSN)

  • 1546-3141

Digital Object Identifier (DOI)

  • 10.2214/AJR.18.20979

Language

  • eng

Conference Location

  • United States