Abstract

Herein, we assessed whether hepatobiliary phase (HBP) signal intensity (SI) can be used to differentiate HCC and non-HCC malignancies within LR-M observations. 106 LR-M patients based on LI-RADS v2018 who underwent gadoxetate-disodium magnetic resonance imaging and surgery from January 2009 to December 2018 were included. SI of LR-M observation on HBP was analyzed by two radiologists and categorized into dark, low and iso-to-high groups. Tumor was classified as dark when more than 50% of tumor showed hypointensity compared to spleen, as low when more than 50% of tumor showed hyperintensity compared to spleen but hypointensity compared to liver parenchyma, and as iso-to-high if there was even a focal iso-intensity or hyperintensity compared to liver parenchyma. Analysis of clinicopathological factors and association between imaging and histology was performed. Out of 106 LR-M, 42 (40%) were showed dark, 61 (58%) showed low, and 3 (3%) showed iso-to-high SI in HBP. Three iso-to-high SI LR-M were HCCs (P = 0.060) and their major histologic differentiation was Edmondson grade 1 (P = 0.001). 43 out of 61 (71%) low SI LR-M were iCCA or cHCC-CCA (P = 0.002). Inter-reader agreement of HBP SI classification was excellent, with a kappa coefficient of 0.872. LR-M with iso-to-high SI in HBP is prone to being HCC while LR-M with low SI in HBP is prone to being tumor with fibrous stroma such as iCCA and cHCC-CCA. Classification of LR-M based on HBP SI may be a helpful method of differentiating HCC from non-HCC malignancies.

Highlights

  • The CT/MRI liver imaging reporting and data system (LI-RADS) includes a special category, LI-RADS M (LR-M) for observations that are probably or definitely malignant but not necessarily hepatocellular carcinoma (HCC) [1]

  • Tumor was classified in the dark group when more than 50% of tumor area showed hypointensity compared to spleen, in the low group when more than 50% of tumor area showed hyperintensity compared to spleen but hypointensity compared to liver parenchyma, and in the iso-to-high group if there was even a focal iso-intensity or hyperintensity compared to liver parenchyma on visual insepction in hepatobiliary phase image [21]

  • Categorical variables are expressed as n (%)

Read more

Summary

Introduction

The CT/MRI liver imaging reporting and data system (LI-RADS) includes a special category, LI-RADS M (LR-M) for observations that are probably or definitely malignant but not necessarily hepatocellular carcinoma (HCC) [1]. The aim of this category, when first introduced, was to maintain the specificity of LR-5 (definitely HCC) without losing the sensitivity to detect malignancies including HCC with atypical imaging features, intrahepatic mass forming. Hepatobiliary phase signal intensity of LR-M observations

Objectives
Methods
Results
Conclusion
Full Text
Published version (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