To review the key pathological alterations of hepatocarcinogenesis and their associated imaging findings.
To provide a brief review of CT/MRI LIRADS v2018 and integrates it into a step-wise approach for interpreting liver MRI in patients at risk of hepatocellular carcinoma (HCC).
I-Development of HCC
Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world with increasing incidence,
especially in Western countries.
The most important clinical risk factor for HCC is cirrhosis,
with about 80% of HCC develop in patients with a cirrhotic liver.
Hepatocarcinogenesis is defined as the gradual transformation of nonmalignant liver cells into HCC.
It is a complex,
multistep process which occurs at two levels;
a) molecular and cellular level,
progressive accumulation of epigenetic and genetic alterations is thought to be triggered...
Findings and procedure details
I-The story of LI-RADS
Liver Imaging and Reporting Data System (LI-RADS) aims to standardize the terminology,
and data collection of liver imaging in patients at risk for hepatocellular carcinoma (HCC).
It was developed by a multi-disciplinary group of professionals in the field of liver cancer imaging including diagnostic and interventional radiologists,
LI-RADS was first released by the American College of Radiology (ACR) in 2011.
This was followed by three major updates in 2013,
2014 and 2017....
The standardized terminology and reporting offered by LI-RADS is very important,
not only for clear radiologist-clinician communication,
but also for the research,
education and training of the radiology trainee.
LI-RADS imaging features reflect the pathological changes occur during hepatocarcinogenesis.
Understanding the rationale and biological basis of LI-RADS imaging features is crucial for the radiologist to interpret liver imaging confidently.
Young radiologists are encouraged to use LI-RADS and be familiar with its recent updates
Mohamed Tarek El-Diasty
King AbdulAziz University Hospital
Sirlin (2014)CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part I.
and Spread: Key Pathologic and Imaging Aspects. Radiology.
2.American College of Radiology (2018)The LI-RADS v2018 Manual.
(2018)Evidence Supporting LI-RADS Major Features for CT- and MR Imaging-based Diagnosis of Hepatocellular Carcinoma: A Systematic Review. Radiology.
Sirlin (2014)CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II....