Aims and objectives
The diagnosis of Hepatocellular Carcinoma (HCC) strongly relies on cross-sectional imaging according to the 2018 European Association for the Study of the Liver (EASL) Guidelines[1].
Conversely,
the most important prognostic factors in terms of recurrence are the Edmondson-Steiner Grade (E-S)[2,3] and Microvascular Invasion (MVI)[2,4]evaluated on the pathological specimen.
Unfortunately,
the preoperative biopsy is not considered a reliable tool[5].
Several studies have correlated different radiological findings to post-surgical or post-transplant recurrence of HCC[6-10],
but at now their definition is not completely standardized and reproducible.
Therefore,
the...
Methods and materials
Patient Population
In this retrospective study,
we included patientswith chronic liver disease who underwent surgical resection for focal liver lesion between June 2015 and June 2018 at Hepatobiliary and Transplant Surgery of University Hospital of Ancona.
All the lesions included were HCC at the surgical specimen.
All the patients had at least one triphasic contrast-enhanced CT or MRI within a month prior to surgery.
Patients with lack of clinical,
radiological or pathological data were excluded.
Imaging Protocol
Pre-surgical examinations were performed with a 64-slices TC...
Results
Patient Demographics and Lesion characteristics
Ninety-two patients (median age: 64 y.o.; interquartile range: 56-72 y.o.) were included.Among the 92 patients,
chronic liver etiology was due to HCV in 33 patients (pts),
to HBV in 14 pts,
to Alcohol in 14 pts and related to miscellaneous etiology in 31 patients.
A total of 112 lesions (median diameter: 22 mm; interquartile range: 10–43 mm) were evaluated respectively in 63 CT and 49 MRI.
At pathological evaluation,
44 lesions had E-S Grade 1 (G1),
48 lesions had G2,...
Conclusion
Application of LI-RADSv2018 score allowed for a moderate to good IRA between readers with different experience.
Significant correlations between some LI-RADSv2018 features and pathological features were found.
References
1.
European Association for the Study of the Liver.,
European Association for the Study of the Liver.
EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma.
Journal of Hepatology.
2018;69:182–236.
2.
Jonas S,
Bechstein WO,
Steinmüller T,
Herrmann M,
Radke C,
Berg T,
et al.
Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis.
Hepatology.
2001;33:1080–6.
3.
Zhou L,
Rui J-A,
Zhou W-X,
Wang S-B,
Chen S-G,
Qu Q.
Edmondson-Steiner grade: A crucial predictor of recurrence and survival in hepatocellular...