Scientific Session 24 — Gastrointestinal - Focal Liver and Biliary DiseaseThursday, May 4, 2017
2218. LI-RADS Use for Comprehensive Management at Veterans Administration Hospitals
Franceschi A1*, Claire P2, DeSantis M2 1. New York University Medical Center, New York, NY; 2. State University of New York, Stony Brook, NY
Address correspondence to A. Franceschi (email@example.com)
Objective: The Liver Imaging Reporting and Data System (LI-RADS), designed for all patients at risk for hepatocellular carcinoma, was developed by the American College of Radiology and designed for utilization with CT and MRI studies of the liver. It has been implemented into clinical practice in the Veterans Administration (VA) hospital system.
Materials and Methods: This study is a retrospective review of 10 patients undergoing enhanced CT and MRI studies with cirrhosis in the VA hospitals system. All subjects were imaged with hepatobiliary contrast agent–enhanced MRI, CT studies, or both. Initial radiologist observations were evaluated retrospectively in terms of segmental location, mass size, and enhancement pattern according to LI-RADS criteria. The initial radiologist observation was compared with serial follow-up CT and MRI examinations.
Results: The mean follow-up interval was 6 months. Seven (70%) of the initial studies demonstrated vivid arterial enhancement, and three (30%) lesions demonstrated isointense signal or low signal intensity on arterial phase at the time of initial examination. Tumor growth, washout, and capsular enhancement were used as discriminator criteria to guide treatment. Six cases with greater than 20-mm lesions were considered LI-RADS category 5 and had at least two additional discriminators. One case demonstrated tumor within the inferior vena cava and was considered LI-RADS category 5V. The patients subsequently underwent either transarterial catheter embolization or radiation therapy.
Conclusion: Our experience at the VA hospital system clearly demonstrates the added value of LI-RADS in streamlining treatment and optimizing patient care, particularly in LI-RADS category 4 and 5 cases.