User and system pitfalls in liver imaging with LI-RADS

Area of Science:

• Radiology
• Medical Imaging
• Hepatocellular Carcinoma Detection

Background:

• The Liver Imaging Reporting and Data System (LI-RADS) standardizes liver imaging for patients at risk of hepatocellular carcinoma.
• Despite widespread adoption, user errors and system limitations persist in clinical practice.

Purpose of the Study:

• To review common user pitfalls in applying LI-RADS v2018.
• To identify and suggest improvements for current LI-RADS deficiencies.

Main Methods:

• Review of common user errors in LI-RADS v2018 application.
• Analysis of inherent system limitations and discordances.

Main Results:

• Identified user pitfalls include inappropriate patient selection, incorrect measurements, and misuse of terminology.
• System pitfalls involve discordance with Organ Procurement and Transplantation Network (OPTN) criteria and rare ancillary features.

Conclusions:

• Addressing user errors and system limitations is crucial for optimizing LI-RADS accuracy.
• Future iterations of LI-RADS should consider improvements to mitigate identified deficiencies.