ArticleJapanese journal of radiology2026
LR-TR viable as an early imaging indicator of local recurrence after radiofrequency ablation for hepatocellular carcinoma: a longitudinal assessment using LI-RADS nonradiation TRA version 2024.
Article in Japanese journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate longitudinal changes of LR-TR Viable observations after radiofrequency ablation (RFA) and characterize their temporal relationship with fulfillment of operational imaging criteria for local recurrence of HCC. MATERIALS AND
methodsThis single-institution retrospective study enrolled treatment-naïve HCC patients who underwent RFA as first-line treatment between 2017 and 2024. Baseline HCC was diagnosed by LR-4/LR-5 categorization according to the LI-RADS CT/MRI Diagnostic Algorithm Version 2018 (LI-RADS Diagnostic v2018) in at-risk patients or by histopathology. Two radiologists chronologically reviewed post-RFA CT/MRI examinations using the LI-RADS CT/MRI Nonradiation Treatment Response Algorithm Version 2024 (LI-RADS Nonradiation TRA v2024) and LI-RADS Diagnostic v2018, with disagreements resolved by a third senior radiologist. An operational imaging endpoint for local recurrence was defined as an ablation-margin assignment of LR-4, LR-5, LR-M, or LR-TIV according to LI-RADS Diagnostic v2018, although this algorithm was originally developed for untreated observations.
resultsA total of 127 patients (median age, 68 years [IQR, 61-74 years]; 87 men, 40 women) with 136 HCC lesions were evaluated across 606 post-RFA lesion-level assessments. During follow-up, 70 lesions (51.5%) were categorized as LR-TR Viable at least once; 64 (91.4%) concurrently or subsequently fulfilled the operational imaging criteria for local recurrence. Among these 64 lesions, 21 (32.8%) had not yet met the criteria at initial LR-TR Viable assignment but did so during subsequent follow-up. In these 21 lesions, the median interval to criteria fulfillment was 5.0 months (IQR, 4.4-13.0). Lesions were smaller at initial LR-TR Viable assignment than at the subsequent examination meeting the operational imaging criteria (1.3 cm versus 2.0 cm; p < 0.001).
conclusionLR-TR Viable assignment preceded fulfillment of the operational LI-RADS Diagnostic v2018 imaging criteria for local recurrence in approximately one-third of lesions, with a smaller lesion size at initial assignment than at subsequent criteria fulfillment.
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