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 followups 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 LIRADS 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.

Vernuccio, F., Cannella, R., Cabibbo, G., Greco, S., Celsa, C., Matteini, F., et al. (2022). Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals. DIAGNOSTICS, 12(5) [10.3390/diagnostics12051187].

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

Vernuccio, Federica
Primo
;
Cannella, Roberto;Cabibbo, Giuseppe;Greco, Silvia;Celsa, Ciro;Matteini, Francesco;Giuffrida, Paolo;Midiri, Massimo;Di Marco, Vito;Brancatelli, Giuseppe
Ultimo
2022-05-10

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 followups 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 LIRADS 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.
Vernuccio, F., Cannella, R., Cabibbo, G., Greco, S., Celsa, C., Matteini, F., et al. (2022). Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals. DIAGNOSTICS, 12(5) [10.3390/diagnostics12051187].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/579173
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