Class and description | Additional requirements |
OPTN class 0 | |
Incomplete or technically inadequate study | Repeat study required for adequate assessment; automatic priority MELD points cannot be assigned on basis of an imaging study categorized as OPTN class 0. |
OPTN class 5 | |
Meets radiographic criteria for HCC, and potentially eligible for MELD exception points. | |
Class 5A: ≥1 cm and <2 cm measured on late arterial or portal venous phase images | Increased contrast enhancement in late hepatic arterial phase and either washout during later phases of contrast enhancement and peripheral rim enhancement on delayed phase, or biopsy confirmation. |
Class 5A-g: same size as OPTN class 5A HCC | Increased contrast enhancement in late hepatic arterial phase and growth by 50% or more documented on serial CT or MR images obtained ≤6 months apart. |
Class 5B: maximum diameter ≥2 cm and ≤5 cm | Increased contrast enhancement in late hepatic arterial phase and either washout during later contrast phases or peripheral rim enhancement (capsule or pseudocapsule) or growth by 50% or more documented on serial CT or MR images obtained ≤6 months apart (OPTN class 5B-g) or biopsy confirmation. |
Class 5T: prior regional treatment for HCC | Any class 5A, 5A-g, or 5B lesion that was automatically approved for MELD HCC exception points upon initial request or extension and has been subsequently ablated. |
Class 5X: maximum diameter ≥5 cm | Increased contrast enhancement in late hepatic arterial phase and either washout during later contrast phases or peripheral rim enhancement (capsule or pseudocapsule). Not eligible for MELD HCC exception points. |
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