This article provides a glimpse into the future of the Liver Imaging Reporting and Data System (LI-RADS), discussing the immediate and long-term plans for its continuing improvement and expansion. To complement the Core and Essentials components of the latest version of LI-RADS, a comprehensive manual will be released soon, and it will include technical recommendations, management guidance, as well as reporting instructions and templates. In this article, we briefly review the process by which LI-RADS has been developed until now, a process guided by a variable combination of data, expert opinion, and desire for congruency with other diagnostic systems in North America. We then look forward, envisioning that forthcoming updates to LI-RADS will occur regularly every 3 to 5 years, driven by emerging high-quality scientific evidence. We highlight some of the key knowledge and technology gaps that will need to be addressed to enable the needed refinements. We also anticipate future expansions in scope to meet currently unaddressed clinical needs. Finally, we articulate a vision for eventual unification of imaging system for HCC screening and surveillance, diagnosis and staging, and treatment response assessment.
Hepatocellular carcinoma Screening and surveillance Diagnosis Diagnostic imaging Practice guidelines
American Association for the Study of Liver Diseases
Liver Imaging Reporting and Data System
Magnetic resonance imaging
Organ Procurement and Transplantation Network
This is a preview of subscription content, log in to check access.
Darnell A, Forner A, Rimola J, et al. (2015) Liver imaging reporting and data system with MR imaging: evaluation in nodules 20 mm or smaller detected in cirrhosis at screening US. Radiology 275:698–707CrossRefPubMedGoogle Scholar
Kim TK, Lee KH, Jang HJ, et al. (2011) Analysis of gadobenate dimeglumine-enhanced MR findings for characterizing small (1–2-cm) hepatic nodules in patients at high risk for hepatocellular carcinoma. Radiology 259:730–738CrossRefPubMedGoogle Scholar
Han KH, Kim DY, Park JY, et al. (2013) Survival of hepatocellular carcinoma patients may be improved in surveillance interval not more than 6 months compared with more than 6 months: a 15-year prospective study. J Clin Gastroenterol 47:538–544CrossRefPubMedGoogle Scholar
Santi V, Trevisani F, Gramenzi A, et al. (2010) Semiannual surveillance is superior to annual surveillance for the detection of early hepatocellular carcinoma and patient survival. J Hepatol 53:291–297CrossRefPubMedGoogle Scholar
Trevisani F, De Notariis S, Rapaccini G, et al. (2002) Semiannual and annual surveillance of cirrhotic patients for hepatocellular carcinoma: effects on cancer stage and patient survival (Italian experience). Am J Gastroenterol 97:734–744CrossRefPubMedGoogle Scholar
Tanabe M, Kanki A, Wolfson T, et al. (2016) Imaging outcomes of liver imaging reporting and data system version 2014 category 2, 3, and 4 observations detected at CT and MR imaging. Radiology 281:129–139CrossRefPubMedGoogle Scholar