Concept:
100% certainty that observation is HCC and, if resection/explantation were performed, would be confirmed pathologically as HCC.
Definition:
Observation with imaging features diagnostic of HCC.
Criteria:
Not definite benign entity, not probable benign entity, not non-HCC malignancy, not tumor in vein, and as follows:
If unsure about category
- Do not characterize as LR-5
- Characterize as LR-4 or LR-M as appropriate
Reporting:
- LR-5 observations must be reported.
- Features seen on CT and MR can be integrated to yield the final LI-RADS category. If this is done, it must be explicitly stated in the radiology report.
- Since LR-5 observations represent definite HCC, they may determine the patient’s eligibility for transplantation or other treatment modalities. Thus LR-5 observations must be reported.
- LR-5 observations may be reported in aggregate if there are numerous observations which share similar features. However, up to five such observations should be individually described in the Findings, if there are no LR-M or LR-5v observations.
Management implications:
- Please see Diagnostic Options for further information
- Contributes to radiology T staging.
Comments:
- Essentially equivalent to OPTN Class 5, therefore may provide HCC exception points for determining priority on liver transplantation list. See UNOS/OPTN policy 3.6.4.4.
- Criteria were selected to provide high specificity for HCC