International perspectives on LI-RADS

Area of Science:

• Hepatobiliary imaging and intervention
• Radiology and medical imaging
• Hepatocellular carcinoma (HCC) diagnosis and management

Background:

• Imaging is critical for diagnosing hepatocellular carcinoma (HCC) in at-risk patients.
• The Liver Imaging Reporting and Data System (LI-RADS) was developed to standardize HCC interpretation and reporting using CT/MRI.
• LI-RADS has expanded to include multiple algorithms for surveillance, contrast-enhanced ultrasound (CEUS), CT/MRI, and treatment response assessment.

Purpose of the Study:

• To summarize HCC risk factors and imaging guidelines across geographically diverse regions.
• To identify perceived strengths and weaknesses of LI-RADS algorithms.
• To solicit expert feedback on limitations and barriers hindering LI-RADS adoption globally.

Main Methods:

• Review of HCC risk factors and imaging guidelines in select international regions.
• Solicitation of feedback from international liver imaging experts.
• Analysis of perceived barriers to LI-RADS algorithm adoption in different patient populations.

Main Results:

• LI-RADS adoption is widespread in North America but less so internationally.
• Geographic variations in HCC risk factors and imaging practices exist.
• Understanding regional differences is key to improving global LI-RADS applicability.

Conclusions:

• Further elucidation of LI-RADS strengths and weaknesses in various regions is needed.
• Addressing identified barriers will inform the development of a more universally adopted LI-RADS system.
• Global collaboration is essential for refining HCC imaging standardization.