From the Guidelines
A hepatic dome LI-RADS 2 lesion is a liver finding that is probably benign according to the Liver Reporting and Data System classification. This category includes lesions that have features strongly favoring benignity, such as typical characteristics of hemangiomas, cysts, focal fat deposition or sparing, or perfusion alterations. These lesions have a very high probability of being non-cancerous and generally do not require specific treatment or intervention.
Key Characteristics of LI-RADS 2 Lesions
- Probably benign lesions with features strongly favoring benignity
- Include typical characteristics of hemangiomas, cysts, focal fat deposition or sparing, or perfusion alterations
- Very high probability of being non-cancerous
- Generally do not require specific treatment or intervention
Management of LI-RADS 2 Lesions
- Routine surveillance imaging, usually at 6-month intervals, to ensure stability
- The hepatic dome location refers to the uppermost portion of the liver that lies just beneath the diaphragm, which can sometimes be challenging to visualize completely on imaging studies
- This classification system helps radiologists and clinicians standardize the reporting of liver lesions in patients with chronic liver disease or at risk for hepatocellular carcinoma, allowing for appropriate management decisions based on the likelihood of malignancy, as supported by recent guidelines 1
Patient Reassurance and Follow-up
- Patients with LI-RADS 2 lesions can generally be reassured about the benign nature of the finding while maintaining appropriate follow-up
- It is essential to note that while the likelihood of malignancy is low, regular follow-up is still necessary to monitor for any changes in the lesion, as recommended by the Liver Reporting and Data System classification 1
From the Research
Definition of Hepatic Dome LR 2 Lesion
A hepatic dome Liver Reporting and Data System (LI-RADS) 2 lesion refers to a liver lesion located in the hepatic dome that is categorized as LR-2, indicating it is probably benign.
LI-RADS Categories
The LI-RADS system categorizes liver lesions into several categories, including:
- LR-1: Definitely Benign
- LR-2: Probably Benign
- LR-3: Intermediate Probability for HCC
- LR-4: Probably HCC
- LR-5: Definite HCC As stated in the study 2, these categories reflect the relative probability of benignity or malignancy of the respective observation.
Characteristics of LR-2 Lesions
LR-2 lesions are characterized as probably benign, meaning they have a low probability of being hepatocellular carcinoma (HCC) 3. The LI-RADS system assigns categories based on major and ancillary image features, which have been developed by the American College of Radiology (ACR) and validated in many studies 3.
Clinical Implications
The LI-RADS system is used to standardize the interpretation and reporting of imaging examinations in patients at risk for HCC 4. The categorization of liver lesions using LI-RADS helps to reduce inter-reader variability and improve communication among radiologists, hepatologists, hepatic surgeons, and oncologists, leading to improved patient management 3. As noted in the study 5, emerging data have provided new insights into the potential of CT/MRI LI-RADS in HCC prognostication, which may help refine the prognostic paradigm of HCC.
Location of the Lesion
The hepatic dome refers to the upper portion of the liver, which is a common location for liver lesions. The location of the lesion can affect its visibility and accessibility for biopsy or treatment. As mentioned in the study 6, the LI-RADS system defines imaging features of the lesions and stratifies the risk of HCC into categories, regardless of the location of the lesion.
Reporting and Data Collection
The LI-RADS system provides a comprehensive framework for standardizing the terminology, techniques, interpretation, reporting, and data collection of liver imaging 5. This helps to ensure that liver lesions are consistently categorized and reported, facilitating communication among healthcare professionals and improving patient outcomes.