Dr. Hooman Noorchashm, PhD

Ultrasound
Why we need a BI-RADS-like system for uterine tumors
Does radiology need a scoring system like BI-RADS for tracking uterine tumors? In this Second Opinion article, Dr. Hooman Noorchashm, PhD, proposes just such a system, which he believes is necessary after a painful personal experience: the death of his wife, Dr. Amy Josephine Reed, from a uterine soft-tissue sarcoma.
February 3, 2019
2016 10 11 13 31 21 852 Am Second Opinion 400
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(A,B) Images from an initial ultrasound examination showed no identifiable lesions and received a consensus ultrasound category of US-1. Nearly the entire liver is visualized, with minimal shadowing (“s”, A and B), and the examination received consensus result of VIS-A. The AFP level was 7.1 ng/mL on assessment six months before the ultrasound, 9.1 ng/mL on assessment three months before examination, and 14.2 ng/mL on assessment on exam day. The AFP result was thus assessed as positive based on a progressive increase on two consecutive tests. The atient was considered to have negative surveillance result according to LI-RADS Ultrasound Surveillance v2017, but positive surveillance result according to LI-RADS Ultrasound Surveillance v2024. (C-D) Axial arterial-phase (C) and portal-venous phase (D) T1-weighted images from subsequent gadoxetic acid-enhanced MRI show a 2-cm arterial-phase hyperenhancing observation (arrow, C) with portal-venous washout (arrow, D) in segment 7. This observation was classified on MRI as LR-5, thus meeting the present study’s reference standard for diagnosis of HCC. The mass is located in the periphery of the liver, an anatomic area where ultrasound visualization can be challenging due to shadowing.
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