Society of abdominal radiology survey of practice patterns in using LI-RADS treatment response criteria in the evaluation of hepatocellular carcinoma post-locoregional treatment

Rony Kampalath; Mishal Mendiratta-Lala; Sara Lewis; Thad Benefield; Vahid Yaghmai; Lauren Burke

doi:10.1007/s00261-023-04022-9

Society of abdominal radiology survey of practice patterns in using LI-RADS treatment response criteria in the evaluation of hepatocellular carcinoma post-locoregional treatment

Abdom Radiol (NY). 2023 Nov;48(11):3401-3407. doi: 10.1007/s00261-023-04022-9. Epub 2023 Sep 2.

Authors

Rony Kampalath¹, Mishal Mendiratta-Lala², Sara Lewis³, Thad Benefield⁴, Vahid Yaghmai⁵, Lauren Burke⁶

Affiliations

¹ Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Orange, CA, 92868, USA. rkampala@hs.uci.edu.
² Radiology, University of Michigan School of Medicine, 1500 East Medical Center Drive, UH B2A209R, Ann Arbor, MI, 48109-5030, USA.
³ Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1234, New York, NY, 10029-6574, USA.
⁴ Carolina Mammography Registry, University of North Carolina at Chapel Hill, CB #7510, Bioinformatics Building Room 3125, Chapel Hill, NC, 27599-7515, USA.
⁵ Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Orange, CA, 92868, USA.
⁶ Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, 2000 Old Clinic, CB# 7510, Chapel Hill, NC, 27599, USA.

PMID: 37658876
DOI: 10.1007/s00261-023-04022-9

Abstract

Purpose: To examine national trends in the adoption and use of the LI-RADS Treatment Response Algorithm.

Methods: Members of the Society of Abdominal Radiology (SAR) Disease-Focused Panel (DFP) on LI-RADS Treatment Response (LR-TR) of hepatocellular carcinoma (HCC) developed a 15-question survey which was distributed to radiologists at academic and private practice institutions around the USA and Canada. The survey focused on HCC-related practice patterns as well as the adoption and use of the LR-TR algorithm.

Results: Of 122 surveys distributed, a total of 76 radiologists responded (62%). Responders were predominantly from academic centers (85%). Nearly all (96%) participate in multidisciplinary hepatic tumor boards and most (67%) have an active liver transplant program. All responders' institutions perform locoregional therapy for HCC, including radiation-based therapy (TARE and SBRT). There was a preference for use of MRI over CT for follow-up after locoregional therapy. All responders were aware of the LR-TR algorithm and nearly all (92%) used the system in routine practice. Radiologists expressed a need for more visual aids related to the LR-TR system. Multiple respondents requested additional clarity within the LR-TR algorithm regarding the evolution of post-treatment radiation changes over time.

Conclusion: Most survey participants use the LR-TR algorithm after locoregional therapy for HCC. Future iterations of the algorithm may benefit from increased clarity regarding response after radiation-based therapies. Educational materials should include more visual aids to improve reader understanding.

Keywords: HCC; Hepatocellular carcinoma; LI-RADS treatment response algorithm; Locoregional therapy.