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Article

Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals

by
Federica Vernuccio
1,2,*,
Roberto Cannella
2,3,
Giuseppe Cabibbo
3,
Silvia Greco
2,
Ciro Celsa
3,4,
Francesco Matteini
2,
Paolo Giuffrida
3,
Massimo Midiri
2,
Vito Di Marco
3,
Calogero Cammà
3 and
Giuseppe Brancatelli
2
1
Department of Radiology, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, Italy
2
Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy
3
Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, Italy
4
Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90127 Palermo, Italy
*
Author to whom correspondence should be addressed.
Diagnostics 2022, 12(5), 1187; https://doi.org/10.3390/diagnostics12051187
Submission received: 21 March 2022 / Revised: 29 April 2022 / Accepted: 5 May 2022 / Published: 10 May 2022
(This article belongs to the Special Issue Advances in Diagnostic Medical Imaging)
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Abstract

Purpose: To assess whether HCC (LR-5) occurrence may be associated with the presence of Liver Imaging Reporting and Data System (LI-RADS) indeterminate observations in patients with hepatitis C virus infection treated with direct acting antiviral (DAA) therapy. Materials and methods: This retrospective study included patients with HCV-related cirrhosis who achieved sustained virologic response (SVR) after DAA therapy between 2015 and 2019 and submitted to CT/MRI follow-ups with a minimum interval time of six months before and after DAA. Two blinded readers reviewed CT/MRI to categorize observations according to LI-RADS version 2018. Differences in rate of LI-RADS 5 observations (i.e., LR-5) before and after SVR were assessed. Time to LR-5 occurrence and risk factors for HCC after DAAs were evaluated by using Kaplan-Meier method and Cox proportional hazard model, respectively. Results: Our final study population comprised 115 patients (median age 72 years) with a median CT/MRI follow-up of 47 months (IQR 26–77 months). Twenty-nine (25.2%) patients were diagnosed with LR-5 after DAA. The incidence of LR-5 after DAAs was 10.4% (12/115) at one year and 17.4% (20/115) at two years. LR-5 occurrence after DAA was significantly higher in patients with Child Pugh class B (log-rank p = 0.048) and with LR-3 or LR-4 observations (log-rank p = 0.024). At multivariate analysis, Child-Pugh class B (hazard ratio 2.62, p = 0.023) and presence of LR-3 or LR-4 observations (hazard ratio 2.40, p = 0.048) were independent risk factors for LR-5 occurrence after DAA therapy. Conclusions: The presence of LR-3 and LR-4 observations significantly increases HCC risk following the eradication of HCV infection.
Keywords: hepatocellular carcinoma; sustained virologic response; chronic hepatitis C; liver cirrhosis; magnetic resonance imaging hepatocellular carcinoma; sustained virologic response; chronic hepatitis C; liver cirrhosis; magnetic resonance imaging

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MDPI and ACS Style

Vernuccio, F.; Cannella, R.; Cabibbo, G.; Greco, S.; Celsa, C.; Matteini, F.; Giuffrida, P.; Midiri, M.; Di Marco, V.; Cammà, C.; et al. Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals. Diagnostics 2022, 12, 1187. https://doi.org/10.3390/diagnostics12051187

AMA Style

Vernuccio F, Cannella R, Cabibbo G, Greco S, Celsa C, Matteini F, Giuffrida P, Midiri M, Di Marco V, Cammà C, et al. Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals. Diagnostics. 2022; 12(5):1187. https://doi.org/10.3390/diagnostics12051187

Chicago/Turabian Style

Vernuccio, Federica, Roberto Cannella, Giuseppe Cabibbo, Silvia Greco, Ciro Celsa, Francesco Matteini, Paolo Giuffrida, Massimo Midiri, Vito Di Marco, Calogero Cammà, and et al. 2022. "Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals" Diagnostics 12, no. 5: 1187. https://doi.org/10.3390/diagnostics12051187

APA Style

Vernuccio, F., Cannella, R., Cabibbo, G., Greco, S., Celsa, C., Matteini, F., Giuffrida, P., Midiri, M., Di Marco, V., Cammà, C., & Brancatelli, G. (2022). Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals. Diagnostics, 12(5), 1187. https://doi.org/10.3390/diagnostics12051187

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