Abstract
BackgroundHepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the second leading cause of cancer death in the world. It is the only tumor that can be diagnosed by imaging only, without a need for histopathological confirmation. CT and MR are the imaging techniques that often allow making a definite diagnosis.This study is a prospective study done by multiphasic contrast-enhanced computed tomography on 25 patients with liver cirrhosis showing 30 hepatic arterial phase hyper-enhancing nodule. Follow-up CT studies for these nodules were performed 4 to 6 months after the initial studyResultsIn the follow-up study, 14 (46.66%) lesions showed size progression; however, only 4 of them had a progression which was more than 50% (threshold progression as described in LI-RADS version18). Nine (30%) lesions showed stationary size, and 7 lesions (23.33%) disappeared. Regarding the enhancement dynamics, 2 lesions developed delayed non-rim washout. By application of the LI-RADS classification, LI-RADS 3 category was noted in 25 lesions, and only 2 lesions evolved in the follow-up to LI-RADS 5 (using version 17 of the LI-RADS), while using LI-RADS version 18, only 3 lesions evolved. Five lesions were classified as LI-RADS 4 category by LI-RADS version 20017, and all these lesions progressed in size with 2 of them (40%) exceeded the growth threshold in the follow-up and progressed to LI-RADS 5. Using version 18 of the LI-RADS system, these lesions are classified as LI-RADS 5 category in the initial study.ConclusionThe findings of the current study support the modification of the LI-RADS scoring system in the LI-RADS version 2018 upgrading arterial hyper-enhancing lesions with non-peripheral washout ranging from 1 to less than 2 cm from LI-RADS 4 to LI-RADS 5.
Highlights
Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the second leading cause of cancer death in the world
CT and MR are the imaging techniques that often allow making a definite diagnosis of HCC without a need to biopsy the lesion
The diagnostic role of DCE ultrasonography relative to DCE-CT and MR imaging remains debated [4, 5], and there is a significant overlap of lesion stiffness in elastography between benign and malignant lesions [6]
Summary
Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the second leading cause of cancer death in the world. It is the only tumor that can be diagnosed by imaging only, without a need for histopathological confirmation. CT and MR are the imaging techniques that often allow making a definite diagnosis. CT and MR are the imaging techniques that often allow making a definite diagnosis of HCC without a need to biopsy the lesion. HCC is one of the tumors that can be diagnosed by imaging only, without the need for histopathological confirmation [1, 2]. The diagnostic role of DCE ultrasonography relative to DCE-CT and MR imaging remains debated [4, 5], and there is a significant overlap of lesion stiffness in elastography between benign and malignant lesions [6]. The pulse sequences at MR imaging can be adjusted to produce images that assess different tissue characteristics to differentiate benign from malignant lesions such as diffusion, perfusion, and viscoelasticity [7, 8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
