Evidence Supporting LI-RADS Major Features for CT- and MR Imaging-based Diagnosis of Hepatocellular Carcinoma: A
An Tang1, Mustafa R Bashir1, Michael T Corwin1
1From the Department of Radiology, Université de Montréal, 1000 rue Saint-Denis, Montréal, QC, Canada H2X 0C2 (A.T., K.N.V.); Department of Radiology and Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, NC (M.R.B.); Department of Radiology, Davis Medical Center, University of California, Sacramento, Calif (M.T.C.); Inland Imaging, Spokane, Wash (I.C.); Caritas-Krankenhaus, Medizinische Klinik 2, Bad Mergentheim, Germany (C.F.D.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (R.K.G.D.); Department of Radiology, Mayo Clinic, Rochester, Minn (E.C.E.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (K.J.F.); Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (H.K.H.); Department of Radiology, American University of Beirut, Beirut, Lebanon (H.K.H.); Department of Radiology, MedStar Georgetown University Hospital, Washington, DC (R.C.J.); Department of Radiology, University of Massachusetts Medical School, Worcester, Mass (A.R.K.); Department of Radiology, Liver Imaging Group, University of California San Diego, Calif (A.M., C.B.S.); Department of Radiology, Naval Medical Center San Diego, San Diego, Calif (R.M.M.); Department of Radiology, Thomas Jefferson University, Philadelphia, Pa (D.G.M.); Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Calif (T.A.M., M.A.O.); Zuckerberg San Francisco General Hospital, San Francisco, Calif (M.A.O.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A.S.).
Abstract:
The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing. Development of LI-RADS has been based on literature review, expert opinion, rounds of testing and iteration, and feedback from users. This article summarizes and assesses the quality of evidence supporting each LI-RADS major feature for diagnosis of HCC, as well as of the LI-RADS imaging features suggesting malignancy other than HCC. Based on the evidence, recommendations are provided for or against their continued inclusion in LI-RADS. © RSNA, 2017 Online supplemental material is available for this article.
