|ECR 2019 / C-3707|
|CT/MRI LI-RADSv2018: inter-reader agreement and correlation with pathology|
Aims and objectives
The diagnosis of Hepatocellular Carcinoma (HCC) strongly relies on cross-sectional imaging according to the 2018 European Association for the Study of the Liver (EASL) Guidelines .
Conversely, the most important prognostic factors in terms of recurrence are the Edmondson-Steiner Grade (E-S) [2,3] and Microvascular Invasion (MVI) [2,4] evaluated on the pathological specimen. Unfortunately, the preoperative biopsy is not considered a reliable tool .
Several studies have correlated different radiological findings to post-surgical or post-transplant recurrence of HCC [6-10], but at now their definition is not completely standardized and reproducible. Therefore, the most important prognostic information is still obtained from the surgical specimen or explanted liver. A radiological marker predicting pathological features would allow for more accurate patient stratification and treatment selection [11,12].
Liver Imaging - Reporting and Data Systems (LI-RADS) have been developed with the main purpose of standardization of liver imaging in patients with chronic liver disease at risk of HCC. This algorithm is still under construction; the last version has been released recently . The key feature of LI-RADS is the defined lexicon and the exact definition of the lesion pattern, aiming to an unequivocal characterization of the observations with improved reproducibility .
The purpose of this study was to evaluate the inter-reader agreement (IRA) between readers with different experience and to determine the correlation of CT/MRI LI-RADSv2018 standardized imaging observations with pathological features of HCC on the surgical specimen in cirrhotic patients.
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Peritoneal metastases – role of diagnostic imaging in therapeutic decision-making process