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LR-M: Probably malignant, not specific for HCC

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Concept:
 
Observation is probably malignant, but imaging features are not specific for HCC
 
Definition: 
 
Observation with one or more imaging features that favor non-HCC malignancy 
 
Characteristic imaging features:
If unsure about category:

LI-RADS Reporting:

  • LR-M observations must be reported.
  • Since LR-M observations represent (or may represent) non-HCC malignancy, their presence can substantially alter patient management.  Thus LR-M observations must be reported.
  • LR-M observations may be reported in aggregate if there are many lesions which are similar in character.

Management implications:  
  • Variable, depending on type of malignancy suspected.
  • Appropriate management may include follow-up, additional imaging, biopsy, resection, or other treatment.
  • Does not contribute to HCC radiology T staging and does not provide HCC exception points for determining priority on liver transplantation list, unless tissue sampling with histology analysis establishes a diagnosis of HCC. See UNOS/OPTN policy.
  • An LR-M observation proven to be HCC at histology should be categorized LR-5 at follow-up imaging.

 




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