Hepatobiliary agents and their role in LI-RADS

Thomas A. Hope, Kathryn J. Fowler, Claude B. Sirlin, Eduardo A.C. Costa, Judy Yee, Benjamin M. Yeh, Jay P. Heiken

Research output: Contribution to journalReview article

69 Citations (Scopus)

Abstract

The Liver Imaging Reporting and Data System (LI-RADS) was introduced with the goal of standardizing the diagnosis of hepatocellular carcinoma. The 2014 version of LI-RADS incorporates the use of hepatobiliary contrast agents (HBAs) into the diagnostic algorithm, including gadoxetate disodium and gadobenate dimeglumine. Three new ancillary features are introduced: hepatobiliary phase (HBP) hypointensity and HBP hypointense rim favor malignancy, while HBP isointensity favors benignity. HBP hyperintensity favors neither malignancy nor benignity. In this review, we describe how to use these new features as well as numerous pitfalls associated with the use ofHBAs, including hemangiomas, cholangiocarcinomas, and focal confluent fibrosis. Importantly, findings on the HBP are not included as major criteria and therefore the criteria for the diagnosis of LI-RADS 5 observations remain unchanged, and so congruence with the Organ Procurement Transplant Network system remains intact. Additionally, we review how the major features in LI-RADS, arterial phase hyperenhancement, threshold growth, and washout and capsule appearance, may be affected with HBAs. Notably with HBAs, hypointensity on the delayed phase, termed the transitional phase, does not qualify as washout appearance due to the possibility of early parenchymal enhancement. It is hoped that the incorporation of HBAs into LI-RADS will help create consistency when interpreting HBA enhanced MRIs.

Original languageEnglish (US)
Pages (from-to)613-625
Number of pages13
JournalAbdominal Imaging
Volume40
Issue number3
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Information Systems
Contrast Media
Liver
Tissue and Organ Procurement
Cholangiocarcinoma
Hemangioma
Capsules
Hepatocellular Carcinoma
Neoplasms
Fibrosis
Transplants
Growth

Keywords

  • Gadobenate dimeglumine
  • Gadoxetate
  • Hepatobiliary agents
  • Hepatocellular carcinoma
  • LI-RADS
  • Liver

ASJC Scopus subject areas

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

Cite this

Hope, T. A., Fowler, K. J., Sirlin, C. B., Costa, E. A. C., Yee, J., Yeh, B. M., & Heiken, J. P. (2014). Hepatobiliary agents and their role in LI-RADS. Abdominal Imaging, 40(3), 613-625. https://doi.org/10.1007/s00261-014-0227-5

Hepatobiliary agents and their role in LI-RADS. / Hope, Thomas A.; Fowler, Kathryn J.; Sirlin, Claude B.; Costa, Eduardo A.C.; Yee, Judy; Yeh, Benjamin M.; Heiken, Jay P.

In: Abdominal Imaging, Vol. 40, No. 3, 01.01.2014, p. 613-625.

Research output: Contribution to journalReview article

Hope, TA, Fowler, KJ, Sirlin, CB, Costa, EAC, Yee, J, Yeh, BM & Heiken, JP 2014, 'Hepatobiliary agents and their role in LI-RADS', Abdominal Imaging, vol. 40, no. 3, pp. 613-625. https://doi.org/10.1007/s00261-014-0227-5
Hope TA, Fowler KJ, Sirlin CB, Costa EAC, Yee J, Yeh BM et al. Hepatobiliary agents and their role in LI-RADS. Abdominal Imaging. 2014 Jan 1;40(3):613-625. https://doi.org/10.1007/s00261-014-0227-5
Hope, Thomas A. ; Fowler, Kathryn J. ; Sirlin, Claude B. ; Costa, Eduardo A.C. ; Yee, Judy ; Yeh, Benjamin M. ; Heiken, Jay P. / Hepatobiliary agents and their role in LI-RADS. In: Abdominal Imaging. 2014 ; Vol. 40, No. 3. pp. 613-625.
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