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Abdominal Radiology

, Volume 43, Issue 1, pp 127–142 | Cite as

CEUS LI-RADS: algorithm, implementation, and key differences from CT/MRI

  • Stephanie R. Wilson
  • Andrej Lyshchik
  • Fabio Piscaglia
  • David Cosgrove
  • Hyun-Jung Jang
  • Claude Sirlin
  • Christoph F. Dietrich
  • Tae Kyoung Kim
  • Juergen K. Willmann
  • Yuko KonoEmail author
Article

Abstract

Contrast-enhanced ultrasound (CEUS) is a specialized form of ultrasound (US) performed with an intravenous injection of microbubble contrast agents. It has been successfully used for a variety of applications including characterization of liver tumors. In April 2014, the American College of Radiology (ACR) convened a working group of international experts to develop ACR CEUS Liver Imaging Reporting and Data System (CEUS LI-RADS). An initial version of CEUS LI-RADS was published in August 2016. Although the CEUS LI-RADS concept and principles for liver lesion characterization, using dynamic contrast enhancement features, are similar to those for CT or MRI, there are significant differences between CT/MRI and CEUS LI-RADS. Therefore, CEUS LI-RADS has different diagnostic features and a unique characterization algorithm. The size of a lesion, the type and degree of arterial phase enhancement, the presence of washout, and the timing and degree of washout are the major features used for categorization. This paper describes key differences between CT/MRI and CEUS, and provides a diagnostic algorithm of CEUS LI-RADS with detailed, step-by-step instructions and imaging examples of CEUS LI-RADS categories.

Keywords

CEUS HCC Diagnosis LI-RADS 

Abbreviations

CEUS

Contrast-enhanced ultrasound

HCC

Hepatocellular carcinoma

LI-RADS

Liver Imaging Reporting and Data System

ICC

Intrahepatic cholangiocarcinoma

ACR

American College of Radiology

AASLD

American Association for the Study of Liver Disease

APHE

Arterial phase hyperenhancement

APS

Arterioportal shunts

TIV

Tumor in vein

MDD

Multi-Disciplinary Discussion

Notes

Acknowledgement

Images are from the University of Calgary using the contrast agent Definity (Lantheus Medical Imaging, Billerica MA).

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Stephanie R. Wilson
    • 1
  • Andrej Lyshchik
    • 2
  • Fabio Piscaglia
    • 3
  • David Cosgrove
    • 4
    • 5
  • Hyun-Jung Jang
    • 6
  • Claude Sirlin
    • 7
  • Christoph F. Dietrich
    • 8
  • Tae Kyoung Kim
    • 9
  • Juergen K. Willmann
    • 10
  • Yuko Kono
    • 11
    Email author
  1. 1.Department of RadiologyUniversity of CalgaryCalgaryCanada
  2. 2.Department of RadiologyThomas Jefferson University HospitalPhiladelphiaUSA
  3. 3.Unit of Internal Medicine, Department of Medical and Surgical SciencesUniversity of Bologna, S. Orsola-Malpighi HospitalBolognaItaly
  4. 4.Hammersmith hospitalLondonUK
  5. 5.King’s College HospitalLondonUK
  6. 6.Department of Medical ImagingUniversity of TorontoTorontoCanada
  7. 7.Department of RadiologyUniversity of CaliforniaSan DiegoUSA
  8. 8.Caritas Krankenhaus Bad MergentheimBad MergentheimGermany
  9. 9.University of TorontoTorontoCanada
  10. 10.Stanford UniversityStanfordUSA
  11. 11.Division of Gastroenterology & HepatologyUniversity of CaliforniaSan DiegoUSA

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