Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
Department of Radiology, Sanya People's Hospital, Sanya, China.
Liver Int. 2022 Oct;42(10):2131-2144. doi: 10.1111/liv.15362. Epub 2022 Jul 25.
Hepatocellular carcinoma (HCC) is the fourth most lethal malignancy with an increasing incidence worldwide. Management of HCC has followed several clinical staging systems that rely on tumour morphologic characteristics and clinical variables. However, these algorithms are unlikely to profile the full landscape of tumour aggressiveness and allow accurate prognosis stratification. Noninvasive imaging biomarkers on computed tomography (CT) or magnetic resonance imaging (MRI) exhibit a promising prospect to refine the prognostication of HCC. The Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system for standardizing the terminology, techniques, interpretation, reporting and data collection of liver imaging. At present, it has been widely accepted as an effective diagnostic system for HCC in at-risk patients. Emerging data have provided new insights into the potential of CT/MRI LI-RADS in HCC prognostication, which may help refine the prognostic paradigm of HCC that promises to direct individualized management and improve patient outcomes. Therefore, this review aims to summarize several prognostic imaging features at CT/MRI for patients with HCC; the available evidence regarding the use of LI-RDAS for evaluation of tumour biology and clinical outcomes, pitfalls of current literature, and future directions for LI-RADS in the management of HCC.
肝细胞癌 (HCC) 是全球第四大致命恶性肿瘤，发病率呈上升趋势。HCC 的治疗遵循了几种临床分期系统，这些系统依赖于肿瘤形态学特征和临床变量。然而，这些算法不太可能描绘出肿瘤侵袭性的全貌，也无法进行准确的预后分层。计算机断层扫描 (CT) 或磁共振成像 (MRI) 的非侵入性成像生物标志物显示出改善 HCC 预后的广阔前景。肝脏影像报告和数据系统 (LI-RADS) 是一个用于规范肝脏影像学的术语、技术、解释、报告和数据收集的综合系统。目前，它已被广泛接受为高危患者 HCC 的有效诊断系统。新出现的数据为 CT/MRI LI-RADS 在 HCC 预后中的应用提供了新的见解，这可能有助于完善 HCC 的预后模式，有望指导个体化管理并改善患者预后。因此，本综述旨在总结 CT/MRI 用于 HCC 患者的几种预后影像学特征；LI-RADS 用于评估肿瘤生物学和临床结局的现有证据、当前文献的局限性以及 LI-RADS 在 HCC 管理中的未来方向。
