Multimodality Assessment of Hepatic Focal Lesions Using Liver Imaging Reporting and Data System (LI- RADS)

Background: The Liver Imaging and Reporting Data System (LI-RADS) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver imaging. The aim of this work was to evaluate the diagnostic performance of LI-RADS version 2017 major features, ancillary features, and categories on Triphasic CT, U/S and MRI for the diagnosis of HCC. Methods: This prospective study was carried out on 70 patients aged over 18 years old, both sexes, with clinical criteria high risks for HCC (Liver cirrhosis, chronic viral hepatitis infection from hepatitis B virus even in absence of cirrhosis, alcoholic steatohepatitis, and non-alcoholic steatohepatitis, or current or previously diagnosed HCC) who were suspected either clinically or by previous cross sectional imaging study (US, CT and MRI) to have a hepatic lesion. Patient further subdivided into two groups: HCC group and non-HCC group. All patients were subjected to triphasic CT, dynamic MRI liver was done on 10 patients.Results: Pre contrast, late arterial, venous washout, LIRAD were significantly higher in HCC group than non-HCC group (P value<0.05). There were significant differences regarding border (Infiltrative, ill-defined, ill-defined exophyte, well defined, and exophytic), and LIRAD types between both groups (P= 0.002, <0.001 respectively). LIRAD can significantly predict diagnosis of HCC (P value<0.001 and AUC=0.813) with 100% sensitivity, 62.5% specificity, 90.3% +PV 100% -PV and 91.86% accuracy.