Learning objectives
To appreciate the most important imaging features of hepatocellular carcinoma in cirrhotic patients.
To understand the method of using the LI-RADS (liver imaging reporting and data system) scoring system,
and how it’s utilized in a major hepatobiliary centre.
Background
The incidence of hepatocellular carcinoma (HCC) is rising,
and it is currently the fifth most common tumour in the world.
The diagnosis of HCC is based on imaging findings in combination with clinical and laboratory findings.
Although there are many risk factors for HCC,
such as chronic viral hepatitis,
toxins and congenital disorders,
it most commonly occurs in patients with liver cirrhosis.
Findings and procedure details
St Vincent’s University Hospital is a tertiary referral centre for hepatobiliary surgery.
As such,
we encounter a large number of patients with cirrhosis and hepatocellular carcinoma.
LI-RADS appliesin patients at high risk for HCC, namely those with:
Cirrhosis OR
Chronic hepatitis B viral infection OR
Current or prior HCC
Including
Adult liver transplant candidates and recipients
Post-transplant patients
LI-RADS doesnot apply in patients:
Without the above risk factors
< 18 years old
With cirrhosis due to congenital hepatic fibrosis
With cirrhosis due to a vascular...
Conclusion
Early and accurate radiological diagnosis of HCC is vital for treatment planning and outcome.
It decreases the variability in interpretation of liver lesions in high risk patients.
This pictorial review provided the reader with the main radiological features of HCC in a cirrhotic liver,
and taught the reader how to apply the LI-RADS score.
References
1.https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS/CT-MRI-LI-RADS-v2017
2.https://www.acr.org/-/media/ACR/Files/RADS/LI-RADS/LIRADS_2017_Essentials.pdf?la=en