Imaging Outcomes of Liver Imaging Reporting and Data System Version 2014 Category 2, 3, and 4 Observations Detected at CT and MR Imaging.
Purpose To determine the proportion of untreated Liver Imaging Reporting and Data System (LI-RADS) version 2014 category 2, 3, and 4 observations that progress, remain stable, or decrease in category and to compare the cumulative incidence of progression in category. Materials and Methods In this retrospective, longitudinal, single-center, HIPAA-compliant, institutional review board-approved study, 157 patients (86 men and 71 women; mean age ± standard deviation, 59.0 years ± 9.7) underwent two or more multiphasic computed tomographic (CT) or magnetic resonance (MR) imaging examinations for hepatocellular carcinoma surveillance, with the first examination in 2011 or 2012. One radiologist reviewed baseline and follow-up CT and MR images (mean follow-up, 614 days). LI-RADS categories issued in the clinical reports by using version 1.0 or version 2013 were converted to version 2014 retrospectively; category modifications were verified with another radiologist. For index category LR-2, LR-3, and LR-4 observations, the proportions that progressed, remained stable, or decreased in category were calculated. Cumulative incidence curves for progression were compared according to baseline LI-RADS category (by using log-rank tests). Results All 63 index LR-2 observations remained stable or decreased in category. Among 166 index LR-3 observations, seven (4%) progressed to LR-5, and eight (5%) progressed to LR-4. Among 52 index LR-4 observations, 20 (38%) progressed to a malignant category. The cumulative incidence of progression to a malignant category was higher for index LR-4 observations than for index LR-3 or LR-2 observations (each P < .001) but was not different between LR-3 and LR-2 observations (P = .155). The cumulative incidence of progression to at least category LR-4 was trend-level higher for index LR-3 observations than for LR-2 observations (P = .0502). Conclusion Observations classified according to LI-RADS version 2014 categories are associated with different imaging outcomes. (©) RSNA, 2016 Online supplemental material is available for this article.
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Masahiro
M
Tanabe
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Akihiko
A
Kanki
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Tanya
T
Wolfson
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Eduardo A C
EA
Costa
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Adrija
A
Mamidipalli
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Marilia P F D
MP
Ferreira
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Cynthia
C
Santillan
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Michael S
MS
Middleton
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Anthony C
AC
Gamst
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Yuko
Y
Kono
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Alexander
A
Kuo
From the Liver Imaging Group, Department of Radiology (M.T., A.K., E.A.C.C., A.M., M.P.F.D.F., C.S., M.S.M., C.B.S.) and Division of Hepatology, Department of Medicine (Y.K., A.K.), University of California, San Diego, 408 Dickinson St, San Diego, CA 92103; and Computational and Applied Statistics Laboratory (CASL), SDSC-University of California, San Diego, La Jolla, Calif (T.W., A.C.G.).
Claude B
CB
Sirlin
D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000592:standards*; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012107:Research Design; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000592:standards*
D003287:Contrast Media