Current State of Evidence for Use of MRI in LI-RADS

Area of Science:

• Radiology
• Hepatology
• Oncology

Background:

• Hepatocellular carcinoma (HCC) is a major global health concern, particularly in patients with chronic liver disease.
• Accurate imaging and risk stratification are crucial for early detection and management of HCC.
• The American College of Radiology Liver Imaging Reporting and Data System (LI-RADS) is the established standard for liver imaging in at-risk populations.

Purpose of the Study:

• To provide a comprehensive review of the LI-RADS framework for hepatocellular carcinoma.
• To discuss the diagnostic and treatment response algorithms within LI-RADS, including recent updates.
• To explore the role of MRI, artificial intelligence, and future directions in LI-RADS.

Main Methods:

• Review of existing literature and evidence supporting the LI-RADS diagnostic and treatment response algorithms.
• Discussion of the pathogenesis of HCC and the application of MRI within the LI-RADS framework.
• Exploration of controversies, comparisons with other systems, and future advancements in liver imaging reporting.

Main Results:

• LI-RADS offers a reproducible system for classifying liver observations in patients at high risk for HCC.
• MRI plays a key role in the LI-RADS diagnostic algorithm, enhancing accuracy.
• Updated LI-RADS algorithms address treatment response, including radiation therapy.

Conclusions:

• LI-RADS is fundamental for standardized liver imaging interpretation and risk stratification of HCC.
• The framework is evolving with advancements in imaging technology and artificial intelligence.
• Understanding LI-RADS is essential for clinicians managing patients at risk for hepatocellular carcinoma.