Feasibility assessment of LI-RADS based ultrasonic screening and CT diagnosis for hepatocellular carcinoma in low middle income setting: observation from a small study

Abstract

AbstractIn our cross-sectional study, we assessed the feasibility of using the ACR LI-RADS screening and diagnostic pathway for Hepatocellular Carcinoma (HCC) in a low-middle-income setting. HCC develops in a well-defined high-risk population, but many countries in this income category lack HCC screening and surveillance guidelines. The ACR’s practical approach through LI-RADS provides a valuable solution. Our study showed that 5.66% of patients had positive ultrasound findings, and significant lesions were detected on multiphasic CT scans. Out of these, 1.89% were diagnosed with definite HCC (LR-5 lesions). We conclude that HCC screening and diagnosis using ACR LI-RADS algorithms are feasible in such settings. However, success hinges on knowledge, skills, and technical capacity building, and it is vital to consider the downstream effects of the screening and surveillance program during the design process.SummaryHCC screening and diagnosis using the ACR LI-RADS algorithms are feasible in low-middle-income settings, making it applicable and recommendable for even lower-income countries. However, successful implementation requires a focus on knowledge, skills, and technical capacity building.Key pointsEligible patients for hepatocellular carcinoma screening and surveillance programs are easily identifiable in low middle income countries.American College of Radiology’s Liver Imaging Reporting and Data Systems algorithm provides a practical approach to hepatocellular carcinoma screening and surveillance.With proper knowledge, skills, and technical capacity, this algorithm is feasible in a low middle income setting, factoring tiered levels of care and referral systems.