Lirads

Question 1

Used and should not be used

Answer 1

Used in cirrhosis, hep b without cirrhosis and known or history of HCC

Not used in cirrhosis due to vascular disorders like budd chiari, cardiac
Less than 18 years and congenital hepatic fibrosis

Question 2

Parameters/features

Answer 2

Non peripheral arterial phase enhancement
Size
Other features: enhancing capsule, delayed washout, threshold growth more than 50% in less than 6 months

LRTIV: tumor in vein (contra to liver transplantation)

LRTR: treated mass: only for local treatment such as RFA, TACE, TARE, external beam radiotherapy, deb, ethanol, cryo, microwave ablations

LRM: probably malignant but not specific for HCC

Observation/mass and not to mention lesion

Question 3

LR1

Answer 3

Definite Non enhancing cyst, hemangioma, scar, focal hepatic fat sparing/infiltration, perfusion alteration, hypertrophic pseudomass

Ancillary findings:
Marked t2 hyper
Iron more in mass (t1 hyper t2 hypo siderotic)
Stable for >2 yrs
Size reduce
Parallel blood pool
Undistorted vessels
Hepatobiliary phase isointensity

Question 4

LR3

Answer 4

Fnh and hepatic adenoma

Question 5

Ancillary findings for HCC

Answer 5

Non enhancing capsule
Fat in mass more than liver
Nodule in nodule
Mosaic architecture
Blood products

Question 6

Ancillary findings for non hcc

Answer 6

Fat sparing
Iron sparing
Subthreso growth
Restricted diff
Usg discrete nodule
Mild to moderate t2 hyper
Hepatobiliary and transitional (same as delayed in ct) phase hypointensity

Question 7

Tumor markers

Answer 7

Afp: >100ng/ml HCC
Ca19 9 >100 units/ml cholangioCA

Question 8

LRTR

Answer 8

Non evaluable: degraded
Non viable: no residual tumor
Equivocal: atypical post treatment enhancement pattern
Viable: residual

Typical post treatment enhancement is Peripheral smooth

Measure largest nodular enhancement without non enhancing areas