CT and MRI LI-RADS Treatment Response Assessment 2024: Core Concepts for Clinical Practice

Area of Science:

• Radiology and Medical Imaging
• Hepatobiliary Malignancies
• Oncology

Background:

• Locoregional therapies are standard for hepatocellular carcinoma (HCC) management, requiring post-treatment imaging surveillance.
• Interpreting imaging after HCC treatment is complex due to variable findings based on therapy type, response, and time.
• Standardized assessment is crucial for timely detection of HCC recurrence or residual tumor viability.

Purpose of the Study:

• To review the updated 2024 CT and MRI Liver Imaging Reporting and Data System (LI-RADS) treatment response assessment algorithm.
• To highlight the algorithm's improvements in standardizing imaging interpretation and reporting for HCC.
• To discuss the clinical applicability and patient care implications of the revised LI-RADS algorithm.

Main Methods:

• The study reviews the updated 2024 LI-RADS treatment response assessment algorithm for HCC.
• It incorporates emerging evidence and user feedback for enhanced accuracy.
• Distinct criteria for radiation- and non-radiation-based therapies are established, alongside ancillary MRI features.

Main Results:

• The updated 2024 LI-RADS algorithm provides standardized criteria for assessing HCC treatment response.
• It differentiates assessment based on radiation vs. non-radiation therapies.
• Ancillary MRI features are integrated to improve the detection of residual tumor viability.

Conclusions:

• The revised LI-RADS algorithm enhances the standardization of imaging interpretation for HCC locoregional therapy.
• It offers improved accuracy in detecting residual tumor viability, impacting patient management decisions.
• The updated algorithm has significant clinical applicability and implications for patient care in HCC management.