LI-RADS and transplantation: challenges and controversies

被引:8
|
作者
Cunha, Guilherme M. [1 ]
Tamayo-Murillo, Dorathy E. [2 ]
Fowler, Kathryn J. [1 ,2 ]
机构
[1] Univ Calif San Diego, Dept Radiol, Liver Imaging Grp, San Diego, CA 92103 USA
[2] Univ Calif San Diego, Dept Radiol, San Diego, CA 92103 USA
关键词
Hepatocellular carcinoma; Imaging diagnosis; Staging; Transplantation; PORTAL-VEIN THROMBOSIS; CONTRAST-ENHANCED ULTRASOUND; HEPATOCELLULAR-CARCINOMA; LIVER-TRANSPLANTATION; TREATMENT RESPONSE; GADOXETIC ACID; DIAGNOSTIC-ACCURACY; ORGAN PROCUREMENT; MRI; ALLOCATION;
D O I
10.1007/s00261-019-02311-w
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Patients with early stage hepatocellular carcinoma (HCC) can be cured by liver transplantation. HCC imaging features on CT or MRI are specific enough to allow for definitive diagnosis and treatment without the need of confirmatory biopsy. When applied to the appropriate at-risk population the Liver Imaging Reporting and Data System (LI-RADS) imaging criteria achieve high specificity and positive predictive value for the diagnosis of HCC. The Organ Procurement and Transplantation Network (OPTN) is the United States organization that aims to assure the adequate and fair distribution of livers across candidates. Given the importance of fair organ allocation, OPTN also provides stringent imaging criteria for the diagnosis of HCC aiming to avoid false positive diagnosis. Although most imaging criteria are identical for both systems, discrepancies between LI-RADS and the current OPTN classification system for HCC diagnosis exists. Main differences include, but are not limited to, the binary approach of OPTN to classify lesions as HCC or not, versus the probabilistic algorithmic approach of LI-RADS, technical and interpretation considerations, and the approach towards treated lesions. The purpose of this article is to highlight the similarities and discrepancies between LI-RADS and the current OPTN criteria for HCC diagnosis and the implications that these differences may have on the management of patients who are transplant candidates.
引用
收藏
页码:29 / 42
页数:14
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