Effect of threshold growth as a major feature on LI-RADS categorization

Victoria Chernyak, Mariya Kobi, Milana Flusberg, Kate C. Fruitman, Claude B. Sirlin

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Liver Imaging Reporting and Data System (LI-RADS) uses major features (arterial phase hyperenhancement [APHE], “washout” [WO], “capsule,” diameter, threshold growth [TG]) to codify probability of hepatocellular carcinoma for each observation. This study assessed the effect of removing TG as a major feature on LI-RADS categorization. Materials and methods: In this HIPAA-compliant, IRB-approved study, all MR and CT clinical reports containing a standardized LI-RADS v2014 template between 4/15–1/17 were retrospectively reviewed for each LR-3, LR-4, and LR-5 reported observation. Two LI-RADS categories were then assigned: one using all LI-RADS major features and one after removing TG as a major feature. The two categories were compared descriptively. Results: The study included 265 patients (172 [65%] male, mean age 63 [±10] years) with 489 observations (median diameter 14 mm, IQR 10–20 mm), of which 345 (71%) had APHE, 307 (63%) had WO, 86 (18%) had “capsule,” and 72 (15%) had TG. Of 86 observations with TG, 47 (65%) were new observations ≥10 mm, 14 (19%) had diameter increase ≥50% in ≤6 months, and 11 (15%) had diameter increase ≥100% in >6 months. Using all major features, 214/489 (44%) observations were LR-3, 129/489 (26%) were LR-4, and 146/489 (30%) were LR-5. After removing TG, 237/489 (48%) were LR-3, 119/489 (24%) were LR-4, and 133 (27%) were LR-5. Removing TG caused a category downgrade for 35/489 (7%, 95% CI 5–10) observations, including 13/146 (9%, 95% CI 3–14) LR-5 observations. Conclusion: 9% of LR-5 observations would be downgraded without TG.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Mar 28 2017

Fingerprint

Information Systems
Liver
Growth
Capsules
Observation
Health Insurance Portability and Accountability Act
Research Ethics Committees
Hepatocellular Carcinoma

Keywords

  • Ancillary feature
  • Hepatocellular carcinoma
  • LI-RADS
  • Major feature
  • Threshold growth

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology

Cite this

Effect of threshold growth as a major feature on LI-RADS categorization. / Chernyak, Victoria; Kobi, Mariya; Flusberg, Milana; Fruitman, Kate C.; Sirlin, Claude B.

In: Abdominal Radiology, 28.03.2017, p. 1-12.

Research output: Contribution to journalArticle

@article{454f63f069cb43dba7cc29f94cf5e2ce,
title = "Effect of threshold growth as a major feature on LI-RADS categorization",
abstract = "Purpose: Liver Imaging Reporting and Data System (LI-RADS) uses major features (arterial phase hyperenhancement [APHE], “washout” [WO], “capsule,” diameter, threshold growth [TG]) to codify probability of hepatocellular carcinoma for each observation. This study assessed the effect of removing TG as a major feature on LI-RADS categorization. Materials and methods: In this HIPAA-compliant, IRB-approved study, all MR and CT clinical reports containing a standardized LI-RADS v2014 template between 4/15–1/17 were retrospectively reviewed for each LR-3, LR-4, and LR-5 reported observation. Two LI-RADS categories were then assigned: one using all LI-RADS major features and one after removing TG as a major feature. The two categories were compared descriptively. Results: The study included 265 patients (172 [65{\%}] male, mean age 63 [±10] years) with 489 observations (median diameter 14 mm, IQR 10–20 mm), of which 345 (71{\%}) had APHE, 307 (63{\%}) had WO, 86 (18{\%}) had “capsule,” and 72 (15{\%}) had TG. Of 86 observations with TG, 47 (65{\%}) were new observations ≥10 mm, 14 (19{\%}) had diameter increase ≥50{\%} in ≤6 months, and 11 (15{\%}) had diameter increase ≥100{\%} in >6 months. Using all major features, 214/489 (44{\%}) observations were LR-3, 129/489 (26{\%}) were LR-4, and 146/489 (30{\%}) were LR-5. After removing TG, 237/489 (48{\%}) were LR-3, 119/489 (24{\%}) were LR-4, and 133 (27{\%}) were LR-5. Removing TG caused a category downgrade for 35/489 (7{\%}, 95{\%} CI 5–10) observations, including 13/146 (9{\%}, 95{\%} CI 3–14) LR-5 observations. Conclusion: 9{\%} of LR-5 observations would be downgraded without TG.",
keywords = "Ancillary feature, Hepatocellular carcinoma, LI-RADS, Major feature, Threshold growth",
author = "Victoria Chernyak and Mariya Kobi and Milana Flusberg and Fruitman, {Kate C.} and Sirlin, {Claude B.}",
year = "2017",
month = "3",
day = "28",
doi = "10.1007/s00261-017-1105-8",
language = "English (US)",
pages = "1--12",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Effect of threshold growth as a major feature on LI-RADS categorization

AU - Chernyak, Victoria

AU - Kobi, Mariya

AU - Flusberg, Milana

AU - Fruitman, Kate C.

AU - Sirlin, Claude B.

PY - 2017/3/28

Y1 - 2017/3/28

N2 - Purpose: Liver Imaging Reporting and Data System (LI-RADS) uses major features (arterial phase hyperenhancement [APHE], “washout” [WO], “capsule,” diameter, threshold growth [TG]) to codify probability of hepatocellular carcinoma for each observation. This study assessed the effect of removing TG as a major feature on LI-RADS categorization. Materials and methods: In this HIPAA-compliant, IRB-approved study, all MR and CT clinical reports containing a standardized LI-RADS v2014 template between 4/15–1/17 were retrospectively reviewed for each LR-3, LR-4, and LR-5 reported observation. Two LI-RADS categories were then assigned: one using all LI-RADS major features and one after removing TG as a major feature. The two categories were compared descriptively. Results: The study included 265 patients (172 [65%] male, mean age 63 [±10] years) with 489 observations (median diameter 14 mm, IQR 10–20 mm), of which 345 (71%) had APHE, 307 (63%) had WO, 86 (18%) had “capsule,” and 72 (15%) had TG. Of 86 observations with TG, 47 (65%) were new observations ≥10 mm, 14 (19%) had diameter increase ≥50% in ≤6 months, and 11 (15%) had diameter increase ≥100% in >6 months. Using all major features, 214/489 (44%) observations were LR-3, 129/489 (26%) were LR-4, and 146/489 (30%) were LR-5. After removing TG, 237/489 (48%) were LR-3, 119/489 (24%) were LR-4, and 133 (27%) were LR-5. Removing TG caused a category downgrade for 35/489 (7%, 95% CI 5–10) observations, including 13/146 (9%, 95% CI 3–14) LR-5 observations. Conclusion: 9% of LR-5 observations would be downgraded without TG.

AB - Purpose: Liver Imaging Reporting and Data System (LI-RADS) uses major features (arterial phase hyperenhancement [APHE], “washout” [WO], “capsule,” diameter, threshold growth [TG]) to codify probability of hepatocellular carcinoma for each observation. This study assessed the effect of removing TG as a major feature on LI-RADS categorization. Materials and methods: In this HIPAA-compliant, IRB-approved study, all MR and CT clinical reports containing a standardized LI-RADS v2014 template between 4/15–1/17 were retrospectively reviewed for each LR-3, LR-4, and LR-5 reported observation. Two LI-RADS categories were then assigned: one using all LI-RADS major features and one after removing TG as a major feature. The two categories were compared descriptively. Results: The study included 265 patients (172 [65%] male, mean age 63 [±10] years) with 489 observations (median diameter 14 mm, IQR 10–20 mm), of which 345 (71%) had APHE, 307 (63%) had WO, 86 (18%) had “capsule,” and 72 (15%) had TG. Of 86 observations with TG, 47 (65%) were new observations ≥10 mm, 14 (19%) had diameter increase ≥50% in ≤6 months, and 11 (15%) had diameter increase ≥100% in >6 months. Using all major features, 214/489 (44%) observations were LR-3, 129/489 (26%) were LR-4, and 146/489 (30%) were LR-5. After removing TG, 237/489 (48%) were LR-3, 119/489 (24%) were LR-4, and 133 (27%) were LR-5. Removing TG caused a category downgrade for 35/489 (7%, 95% CI 5–10) observations, including 13/146 (9%, 95% CI 3–14) LR-5 observations. Conclusion: 9% of LR-5 observations would be downgraded without TG.

KW - Ancillary feature

KW - Hepatocellular carcinoma

KW - LI-RADS

KW - Major feature

KW - Threshold growth

UR - http://www.scopus.com/inward/record.url?scp=85016109612&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016109612&partnerID=8YFLogxK

U2 - 10.1007/s00261-017-1105-8

DO - 10.1007/s00261-017-1105-8

M3 - Article

SP - 1

EP - 12

JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

ER -