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LR-3 and LR-4 Lesions Are More Likely to Be Hepatocellular Carcinoma in Transplant Patients with LR-5 or LR-TR Lesions.

Publication ,  Conference
Lee, T-H; Hirshman, N; Cardona, DM; Berg, CL; Fowler, KJ; Bashir, MR; Ronald, J
Published in: Dig Dis Sci
November 2022

BACKGROUND: Liver Imaging Reporting and Data System (LI-RADS) classifies liver nodules from LR-1 to LR-5 based on risk for hepatocellular carcinoma (HCC). It is challenging to know the nature of the LR-3 and LR-4 lesions. AIMS: To test our hypothesis that in patients with a definite HCC (LR-5) or treated HCC (LR-TR), a coexisting LR-3 or LR-4 lesion is more likely to represent HCC compared to patients without LR-5 or LR-TR lesions. METHODS: We conducted a retrospective study including all adult patients who received liver transplantation in our institution from 1/1/2014 to 3/3/2020 who had any LR-3 or LR-4 lesion on pre-transplant MRI. RESULTS: Seventy-eight patients were included in the final cohort (115 LR-3 and LR-4 lesions total). When accompanied by LR-5 or LR-TR lesions, 41% (28/69) of LR-3 lesions were HCC compared to 12% (3/25) when not accompanied by LR-5 LR-TR lesions. When accompanied by LR-5 or LR-TR lesions, 83% (10/12) of LR-4 lesions were HCC, versus 33% (3/9) when not accompanied by LR-5 or LR-TR lesions. In a multivariable analysis of all lesions, the presence of a LR-5 or LR-TR lesion was significantly associated with LR-3 or LR-4 lesions representing HCC (OR 6.4, p = 0.01). CONCLUSION: LR-3 and LR-4 lesions are more likely to be HCC in patients with LR-5 or LR-TR lesions. The presence of coexisting definite HCC may be a useful diagnostic feature to improve risk stratification of lesions without typical imaging features of HCC. This may also affect decision-making prior to liver transplant when HCC burden must be accurately determined.

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Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

November 2022

Volume

67

Issue

11

Start / End Page

5345 / 5352

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Magnetic Resonance Imaging
  • Liver Neoplasms
  • Humans
  • Gastroenterology & Hepatology
  • Carcinoma, Hepatocellular
  • Adult
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Lee, T.-H., Hirshman, N., Cardona, D. M., Berg, C. L., Fowler, K. J., Bashir, M. R., & Ronald, J. (2022). LR-3 and LR-4 Lesions Are More Likely to Be Hepatocellular Carcinoma in Transplant Patients with LR-5 or LR-TR Lesions. In Dig Dis Sci (Vol. 67, pp. 5345–5352). United States. https://doi.org/10.1007/s10620-022-07428-5
Lee, Tzu-Hao, Nathan Hirshman, Diana M. Cardona, Carl L. Berg, Kathryn J. Fowler, Mustafa R. Bashir, and James Ronald. “LR-3 and LR-4 Lesions Are More Likely to Be Hepatocellular Carcinoma in Transplant Patients with LR-5 or LR-TR Lesions.” In Dig Dis Sci, 67:5345–52, 2022. https://doi.org/10.1007/s10620-022-07428-5.
Lee T-H, Hirshman N, Cardona DM, Berg CL, Fowler KJ, Bashir MR, et al. LR-3 and LR-4 Lesions Are More Likely to Be Hepatocellular Carcinoma in Transplant Patients with LR-5 or LR-TR Lesions. In: Dig Dis Sci. 2022. p. 5345–52.
Lee, Tzu-Hao, et al. “LR-3 and LR-4 Lesions Are More Likely to Be Hepatocellular Carcinoma in Transplant Patients with LR-5 or LR-TR Lesions.Dig Dis Sci, vol. 67, no. 11, 2022, pp. 5345–52. Pubmed, doi:10.1007/s10620-022-07428-5.
Lee T-H, Hirshman N, Cardona DM, Berg CL, Fowler KJ, Bashir MR, Ronald J. LR-3 and LR-4 Lesions Are More Likely to Be Hepatocellular Carcinoma in Transplant Patients with LR-5 or LR-TR Lesions. Dig Dis Sci. 2022. p. 5345–5352.
Journal cover image

Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

November 2022

Volume

67

Issue

11

Start / End Page

5345 / 5352

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Magnetic Resonance Imaging
  • Liver Neoplasms
  • Humans
  • Gastroenterology & Hepatology
  • Carcinoma, Hepatocellular
  • Adult
  • 3202 Clinical sciences
  • 1103 Clinical Sciences