Modified on: Thu, 16 Jun, 2022 at 3:10 PM
FAQ-134: What is a CEUS LI-RADS observation? How does it differ from a CT/MRI observation?
An observation is a distinctive area compared to background liver at imaging. On CT and MRI, it may be a lesion or pseudolesion such as an arterioportal shunt. Unlike in CT or MRI, vascular pseudolesions are not seen on CEUS. Thus, almost all CEUS observations are true lesions.
Did you find FAQ-134 helpful? Yes No
FAQ-135: I am not sure if my patient has cirrhosis. Can I apply CEUS LI-RADS?
You can apply CEUS LI-RADS and provide a conditional category. For example: “25 mm mass with APHE and washout. If the patient has cirrhosis or chronic hepatitis B, this meets criteria for CEUS LR-5 (definitely HCC).” If available, you can add elastography to the ultrasound exam to evaluate liver stiffness (or shear wave speed). If the elastographic measurement exceeds a validated threshold for cirrhosis using your scanner, you may provide a provisional CEUS LI-RADS category, making sure to comment that this assumes a diagnosis of cirrhosis as suggested by “ultrasound elastography stiffness of [XX] kPa (or shear wave speed of [XX] m/s)”.
Did you find FAQ-135 helpful? Yes No
FAQ-136: I do not see a lesion on precontrast US, can I do CEUS?
CEUS LI-RADS v2018 applies only to observations visible on precontrast US. Although CEUS LI-RADS does not yet address CEUS of nodules occult on precontrast US, expert CEUS practitioners may use anatomic landmarks to co-localize and assess CT- or MRI-detected observations.
Did you find FAQ-136 helpful? Yes No
FAQ-137:Can CEUS LI-RADS be used in transplant candidates?
CEUS LI-RADS can be used in transplant candidates if indicated clinically. Since UNOS does not officially recognize CEUS, however, a patient with a CEUS LR-5 observation needs multiphasic CT/MRI for diagnosis verification and staging prior to receiving HCC exception points.
Did you find FAQ-137 helpful? Yes No
FAQ-138: I have seen other systems called CEUS LI-RADS. Which is the official version?
ACR CEUS LI-RADS® is the official CEUS system endorsed by the ACR. It was developed by an international working group of experts, received critical feedback from and was approved by the ACR LI-RADS Steering Committee, and is included in the ACR LI-RADS Manual along with companion US and CT/MRI systems. Other schemes called "CEUS LI-RADS” are not ACR endorsed, Steering Committee approved, or included in the ACR LI-RADS Manual.
Did you find FAQ-138 helpful? Yes No
FAQ-139: Why does LI-RADS not apply to patients without risk factors, to patients less than 18 years old, or to patients with cirrhosis due to congenital hepatic fibrosis?
Did you find FAQ-139 helpful? Yes No
FAQ-140: Why does LI-RADS not apply to patients with cirrhosis due to a vascular disorder such as hereditary hemorrhagic telangiectasia, Budd-Chiari syndrome, chronic portal vein occlusion, cardiac congestion, or diffuse nodular regenerative hyperplasia?
Did you find FAQ-140 helpful? Yes No
FAQ-141: Why shouldn’t I assign a LI-RADS category for path-proven malignancies and for path-proven benign lesions of non-hepatocellular origin?
Did you find FAQ-141 helpful? Yes No
FAQ-142:Should I assign a LI-RADS category to path-proven benign lesions of hepatocellular origin (e.g., regenerative or dysplastic nodules)?
Did you find FAQ-142 helpful? Yes No
Did you find it helpful?
Sorry we couldn't be helpful. Help us improve this article with your feedback.