CT Scan - Lirad 4 Liver Lesion 1.5cm ?

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gipper11
Regular Member


Date Joined Feb 2014
Total Posts : 26
   Posted 3/3/2017 4:57 PM (GMT -7)   
My wife has NASH and has been on the Liver Transplant list at the University of Washington for about 2 1/2 years. Her bloodworm has been stable and the doctor mentioned putting her on the inactive list. However at there six month follow up she had a CT Scan and was told there was a small lesion that was too small to determine what it was and scheduled her for another CT Scan in three months end of March. We had an appointment with her local liver doctor and I noticed on her chart a note stating "Lirad 4 Liver Lesion 1.5cm. Does this mean she has cancer or they are just trying to determine if it is or not, the transplant doctor mention lesions on the liver was common with cirrhosis patients and didn't seem very worried.I know you are not doctors but has anyone here had this?

ppm guy
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Date Joined Apr 2010
Total Posts : 1116
   Posted 3/3/2017 7:51 PM (GMT -7)   
hi gipper11 and welcome,
Really sorry to hear of your wifes condition..
I don't have cancer, my twin does. stage 3 HCC.

LIRAD is "liver imaging reporting and data". it is used to simplifly lesion interpretation. LR-5 is cancer, with LR-4,it does not have all the features required to be cancer..

all liver patients with significant liver damage (stage 3 or worse) are screened every 6 months for HCC. that is why your Dr said lesions are common.

you said, your wife had bloodwork recently. did she have her AFP(alpha fetaprotein) checked? it is used to determine the poosibility of a tumor.

since you have been listed, youre probably getting the best care available. transplant teams are the EXPERTS.
if you do have cancer (god forbid), you will get extra points added to your meld score. this will move you into a much more favorable place on the list..

please keep in touch, hopefully some of our hcc people will chime in. im here for you!!!

gipper11
Regular Member


Date Joined Feb 2014
Total Posts : 26
   Posted 3/4/2017 11:26 AM (GMT -7)   
Thanks I definitely will keep in touch, I am sure they tested her AFP but they didn't mention it as being high. The liver team mentioned they may place her on the inactive list if the lesion isn't cancer. Her MELD score has been around 13-15 since being listed. He does have a blocked portal vein, that is why she was evaluated at the beginning. They said if her status changed she would be moved back to the active list, they want to not give her a CT Scan every six months if they don't need to.

gipper11
Regular Member


Date Joined Feb 2014
Total Posts : 26
   Posted 3/4/2017 11:28 AM (GMT -7)   
By the way I have been monitoring this site for probably more than 5 years and have made a few posts in the past, about NASH, it seems that there aren't a lot of people here with it.

ppm guy
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Date Joined Apr 2010
Total Posts : 1116
   Posted 3/4/2017 6:12 PM (GMT -7)   
I get a ultrasound every 6 months for cancer detection. If anything changes on ultrasound my Dr orders a CT scan.. my hepatologist is always concerned about my status, because of my brothers HCC diagnosis.
my dr really isn't concerned with mild elevations of AFP. mild elevations are common with cirrhosis. I had cirrhosis until 2013, when I finally passed the hep c virus.. I was very lucky..my liver healed enough to be full functioning, and healthy..

.youre right, we don't get many posts about NASH. Since NASH is mostly asymptomatic, it is usually detected during unrelated dr visits , that require bloodwork..

Much respect to you. I know how difficult it is dealing with ESLD. Let me know how her next scan comes out

MamaLama
Forum Moderator


Date Joined Oct 2010
Total Posts : 4806
   Posted 3/5/2017 7:51 PM (GMT -7)   
gipper 11. I am glad to see your posts but sorry she is dealing with NASH. Mike was very very ill in 2010 with multiple diagnoses...Hep C and alcoholic cirrhosis. He had horrible edema, was crazed with hepatic encephalopathy. Then his AFP started climbing...and they started suspecting a tumor. They tested often, as these are not unusual with liver disease. When he stopped drinking his MELD score dropped from mid 20s to mid teens like hers. But when the tumor lit up their tests, he got tumor points and went back to the top of the list here in Florida. From his biopsy to TP was about 2.5 months. The good news is that was May 2011 so he is coming up on 6 years post TP and 6.5 years sober and 3 years Hep C free. He still gets tested all the time, but we are convinced something ELSE will get him in the end.

Our best to you both. Mama Lama
MamaLama, Forum moderator - Hepatitis
Partner received liver transplant (May 1, 2011) FL
Hep C 1a Treatment - Sovaldi/Olysio (March - May 2014)
Undetected since week 4. Undetected 12 weeks post treatment.

gipper11
Regular Member


Date Joined Feb 2014
Total Posts : 26
   Posted 4/16/2017 5:47 AM (GMT -7)   
We got some good news after the last CT Scan, The enhanced area and the washout was gone, the lesion is the same size as before and they are going to do an MRI in 3 months to determine once and for all is it is cancer. They think it is most likely just fat. The rest of her workup was stable her MELD score was only 12.

Thanks for all your support.

MamaLama
Forum Moderator


Date Joined Oct 2010
Total Posts : 4806
   Posted 4/22/2017 9:34 AM (GMT -7)   
gipper11,

great news that things are calmed down.

most important...no alchohol and keep the diet light...chicken and fish instead of roasts and chops, avoid beef if possible, reduce sodium, stay very hydrated with 6-8 cups of water a day. same as healthy heart stuff. limit carbs, good fats...the usual.

mike had the worst encephalopathy after a big meal...which was rare because he felt so poorly AND seemed not to be able to taste things correctly.

best to you both,

hugs,

Mama Lama
MamaLama, Forum moderator - Hepatitis
Partner received liver transplant (May 1, 2011) FL
Hep C 1a Treatment - Sovaldi/Olysio (March - May 2014)
Undetected since week 4. Undetected 12 weeks post treatment.

gipper11
Regular Member


Date Joined Feb 2014
Total Posts : 26
   Posted 6/30/2017 7:17 PM (GMT -7)   
We just had the MRI and I don't think it turned out th way we wished it had. My wife will have another MRI done in 3 months end of September. This is the result of the one she had a few days ago.

IMPRESSION:
1. Segment 5/6 lesion corresponds with lesion seen on prior CT examinations
demonstrates arterial enhancement without washout and mild T2 hyperintensity.
Fat is present within the lesion. LI-RADS 4.

2. Two additional arterially enhancing lesions liver without washout, which
demonstrate mild T2 hyperintensity. Without fat present in the lesions.
LI-RADS 3.

3. Chronic portal vein thrombosis.

4. Cirrhotic liver with sequela of portal hypertension.

gipper11
Regular Member


Date Joined Feb 2014
Total Posts : 26
   Posted 6/30/2017 7:20 PM (GMT -7)   
Here is a better version:

Lesion 1:
Segment 5/6, series 601-2/48, 9 x 9 mm, arterial enhancement without washout
and mild T2 hyperintensity. Fat is present within the lesion, as was seen on
prior CT examinations.
This lesion is similar in size as compared with hypodensity seen on prior CTs.
There is no vascular invasion.
LIRADS Category: 4

Lesion 2:
Segment 6, series 601-2/49, 13 x 13 mm, arterial enhancement without washout
and mild T2 hyperintensity.
This lesion is not well appreciated on prior CT examinations. There is no
vascular invasion.
LIRADS Category: 3

Lesion 3:
Segment 8, series 601-2/80, 7 x 11 mm, arterial enhancement without washout
and mild T2 hyperintensity.
This lesion is not well appreciated on prior CT examinations. There is no
vascular invasion.
LIRADS Category: 3

gipper11
Regular Member


Date Joined Feb 2014
Total Posts : 26
   Posted 6/30/2017 7:26 PM (GMT -7)   
Her AFP is almost normal:

Alpha Fetoprotein (Nonmaternal) 8.7 ng/mL 0.0 - 8.5 ng/mL

ppm guy
Veteran Member


Date Joined Apr 2010
Total Posts : 1116
   Posted 7/1/2017 11:05 AM (GMT -7)   
Hi gipper 11,
sorry to hear this news. Best of luck on her next MRI. Was there any explanation on the signifance of the normal AFP, and the stability of lesion 1?
prayers to the two of you
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