USE OF TRIPHASIC CT LI-RADS V 2018 IN PATIENTS UNDERGOING DYNAMIC CONTRAST-ENHANCED CT LIVER FOR HEPATIC LESION CHARACTERIZATION

ABSTRACT OBJECTIVES This study aimed to characterize hepatic observations and evaluate the frequency of LI-RADS v2018 categories in a high-risk Pakistani population using triphasic CT. METHODOLOGY A retrospective cross-sectional observational study was conducted at the Radiology Department of Khyber Teaching Hospital in Peshawar from March 2021 to September 2022. Fifty-five high-risk patients (cirrhosis/chronic hepatitis B) underwent triphasic CT, and 80 Observations were independently categorized by two radiologists using LI-RADS v2018 major features. Histopathological correlation was assessed where available. RESULTS Out of 55 patients (80 observations) in our study, the LI-RADS distribution was: LR-5 in 61 (76.25%), LR-4 in 4 (5%), LR-M in 3 (3.75%), LR-TIV in 7 (8.75%), LR-1/2/3 in 5 (6.25%). Non-rem arterial phase hyperenhancement was the most frequent feature (81.3%). All LR-5 lesions showed non-rim APHE and washout. In the subset with histopathology (n=12), LR-5 showed 100% concordance with HCC (7/7), and LR-M showed 100% concordance with cholangiocarcinoma (3/3). CONCLUSION Triphasic CT LI-RADS v2018 effectively categorized hepatic findings in high-risk Pakistani patients, with LR-5 being the most frequent category and demonstrating strong histopathological correlation; however, the high LR-5 prevalence suggests potential selection bias inherent to the referral-based setting. The system provides a standardized reporting framework suitable for local clinical practice. KEYWORDS: Hepatocellular Carcinoma, Liver Imaging Reporting and Data System (LI-RADS), Dynamic Contrast-Enhanced CT, Triphasic CT, Pakistan