Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals
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 retrospect...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-05-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/12/5/1187 |
| _version_ | 1797500428712148992 |
|---|---|
| author | Federica Vernuccio Roberto Cannella Giuseppe Cabibbo Silvia Greco Ciro Celsa Francesco Matteini Paolo Giuffrida Massimo Midiri Vito Di Marco Calogero Cammà Giuseppe Brancatelli |
| author_facet | Federica Vernuccio Roberto Cannella Giuseppe Cabibbo Silvia Greco Ciro Celsa Francesco Matteini Paolo Giuffrida Massimo Midiri Vito Di Marco Calogero Cammà Giuseppe Brancatelli |
| author_sort | Federica Vernuccio |
| collection | DOAJ |
| description | 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 <i>p</i> = 0.048) and with LR-3 or LR-4 observations (log-rank <i>p</i> = 0.024). At multivariate analysis, Child-Pugh class B (hazard ratio 2.62, <i>p</i> = 0.023) and presence of LR-3 or LR-4 observations (hazard ratio 2.40, <i>p</i> = 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. |
| first_indexed | 2024-03-10T03:02:46Z |
| format | Article |
| id | doaj.art-4470bb682e8e4a0cbb450f3e77018ba8 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T03:02:46Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-4470bb682e8e4a0cbb450f3e77018ba82023-11-23T10:40:36ZengMDPI AGDiagnostics2075-44182022-05-01125118710.3390/diagnostics12051187Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting AntiviralsFederica Vernuccio0Roberto Cannella1Giuseppe Cabibbo2Silvia Greco3Ciro Celsa4Francesco Matteini5Paolo Giuffrida6Massimo Midiri7Vito Di Marco8Calogero Cammà9Giuseppe Brancatelli10Department of Radiology, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalySection of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, ItalySection of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, ItalySection of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, ItalySection of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, ItalyDepartment of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, ItalySection of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, ItalyPurpose: 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 <i>p</i> = 0.048) and with LR-3 or LR-4 observations (log-rank <i>p</i> = 0.024). At multivariate analysis, Child-Pugh class B (hazard ratio 2.62, <i>p</i> = 0.023) and presence of LR-3 or LR-4 observations (hazard ratio 2.40, <i>p</i> = 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.https://www.mdpi.com/2075-4418/12/5/1187hepatocellular carcinomasustained virologic responsechronic hepatitis Cliver cirrhosismagnetic resonance imaging |
| spellingShingle | Federica Vernuccio Roberto Cannella Giuseppe Cabibbo Silvia Greco Ciro Celsa Francesco Matteini Paolo Giuffrida Massimo Midiri Vito Di Marco Calogero Cammà Giuseppe Brancatelli Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals Diagnostics hepatocellular carcinoma sustained virologic response chronic hepatitis C liver cirrhosis magnetic resonance imaging |
| title | Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals |
| title_full | Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals |
| title_fullStr | Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals |
| title_full_unstemmed | Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals |
| title_short | Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals |
| title_sort | role of li rads indeterminate observations in the risk of hepatocellular carcinoma after hcv eradication with direct acting antivirals |
| topic | hepatocellular carcinoma sustained virologic response chronic hepatitis C liver cirrhosis magnetic resonance imaging |
| url | https://www.mdpi.com/2075-4418/12/5/1187 |
| work_keys_str_mv | AT federicavernuccio roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT robertocannella roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT giuseppecabibbo roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT silviagreco roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT cirocelsa roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT francescomatteini roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT paologiuffrida roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT massimomidiri roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT vitodimarco roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT calogerocamma roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals AT giuseppebrancatelli roleofliradsindeterminateobservationsintheriskofhepatocellularcarcinomaafterhcveradicationwithdirectactingantivirals |