Toward a standardized system for hepatocellular carcinoma diagnosis using computed tomography and MRI

Contrast-enhanced computed tomography and MRI are frequently used for the noninvasive diagnosis of hepatocellular carcinoma (HCC). Despite their important role in diagnosis and management of HCC, until recently, there has been no standardized system for their interpretation, reporting and data collection. In 2008, the American College of Radiology convened a committee to develop such a standardized system. This article reviews the role of computed tomography and MRI in the diagnosis and management of HCC; the need for a standardized imaging interpretation system; current HCC imaging criteria included in management guidelines endorsed by the European Association for the Study of Liver, American Association for Study of Liver Diseases, United Network for Organ Sharing and Asian Pacific Association for the Study of the Liver; and the limitations of these criteria. The article then provides an overview of the Liver Imaging Reporting and Data System and discusses future directions.