التفاصيل البيبلوغرافية
| العنوان: |
Evaluation of LI-RADS 3 category by magnetic resonance in US-detected nodules ≤ 2 cm in cirrhotic patients. |
| المؤلفون: |
Darnell, Anna, Rimola, Jordi, Belmonte, Ernest, Ripoll, Enric, Garcia-Criado, Ángeles, Caparroz, Carla, Díaz-González, Álvaro, Vilana, Ramón, Reig, María, Ayuso, Carmen, Bruix, Jordi, Forner, Alejandro |
| المصدر: |
European Radiology; Jul2021, Vol. 31 Issue 7, p4794-4803, 10p, 1 Black and White Photograph, 1 Diagram, 5 Charts |
| مصطلحات موضوعية: |
MAGNETIC resonance imaging, MAGNETIC resonance, SENSITIVITY & specificity (Statistics), DIAGNOSIS, HEPATOCELLULAR carcinoma, SOLITARY pulmonary nodule |
| مستخلص: |
Objectives: Liver Imaging Reporting and Data System (LI-RADS) for hepatocellular carcinoma (HCC) diagnosis in high-risk patients is a dynamic system, which was lastly updated in 2018. We aimed to evaluate the accuracy for HCC diagnosis of LI-RADS v2018 with magnetic resonance imaging (MRI) with extracellular contrast for solitary nodules ≤ 20 mm detected during ultrasound (US) surveillance in cirrhotic patients, with particular interest in those observations categorized as LI-RADS 3. Methods: Between November 2003 and February 2017, we included 262 consecutive cirrhotic patients with a newly US-detected solitary ≤ 20-mm nodule. A LI-RADS (LR) v2018 category was retrospectively assigned. The diagnostic accuracy for each LR category was described, and the main MRI findings associated with HCC diagnosis were analyzed. Results: Final diagnoses were as follows: 197 HCC (75.2%), 5 cholangiocarcinoma (1.9%), 2 metastasis (0.8%), and 58 benign lesions (22.1%); 0/15 (0%) LR-1, 6/26 (23.1%) LR-2, 51/74 (68.9%) LR-3, 11/12 (91.7%) LR-4, 126/127 (99.2%) LR-5, and 3/8 (37.5%) LR-M were HCC. LR-5 category displayed a sensitivity and specificity of 64% (95% CI, 56.8–70.7) and 98.5% (95% CI, 91.7–100), respectively. Considering also LR-4 as diagnostic for HCC, the sensitivity slightly increased to 69.5% (95% CI, 62.6–75.9) with minor impact on specificity (96.2%; 95% CI, 89.3–99.6). Regarding LR-3 observations, 51 out of 74 were HCC, 2 were non-HCC malignancies, and 20 out of 21 LR-3 nodules > 15 mm (95.2%) were finally categorized as HCC. Conclusions: The high probability of HCC in US-detected LR-3 observations (68.9%) justifies triggering an active diagnostic work-up if intended to diagnose HCC at a very early stage. Key Points: • In cirrhotic patients with nodules ≤ 20 mm detected during US surveillance, 51 out of 74 (68.9%) of LR-3 nodules by MRI corresponded to an HCC. • In LR-3 nodules, HCC diagnosis was closely related to baseline tumor size. All 5 nodules smaller than 1 cm were diagnosed as benign. Oppositely, 20 out of 21 LR-3 observations > 15 mm (95.2%) were diagnosed as HCC. • The high probability of HCC in US-detected LR-3 observations justifies triggering an active diagnostic work-up if intended to diagnose HCC at a very early stage. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
