Abdominal Radiology

, Volume 43, Issue 1, pp 231–236 | Cite as

LI-RADS: a glimpse into the future

  • Claude B. SirlinEmail author
  • Ania Z. Kielar
  • An Tang
  • Mustafa R Bashir
Review Paper


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


Contrast-enhanced ultrasound


Computed tomography


Extracellular agents


Intrahepatic cholangiocarcinoma


Hepatobiliary agents


Hepatocellular carcinoma


Liver Imaging Reporting and Data System


Magnetic resonance imaging


Organ Procurement and Transplantation Network


  1. 1.
    American College of Radiology (2017) Liver imaging reporting and data system. Latest version retrieved from
  2. 2.
    OPaTN (2017) OPTN/UNOS policy 9: allocation of livers and liver-intestines. Accessed 4 Mar 2017
  3. 3.
    Bruix J, Sherman M (2011) Management of hepatocellular carcinoma: an update. Hepatology 53:1020–1022CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    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
  5. 5.
    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
  6. 6.
    Tang A, Cruite I, Mitchell DG, Sirlin CB (2017) Hepatocellular carcinoma imaging systems: why they exist, how they have evolved, and how they differ. Abdom Radiol (NY). Scholar
  7. 7.
    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
  8. 8.
    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
  9. 9.
    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
  10. 10.
    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
  11. 11.
    Santillan C, Fowler K, Kono Y, Chernyak V (2017) LI-RADS major features: CT, MRI with extracellular agents, and MRI with hepatobiliary agents. Abdom Radiol (NY). Scholar
  12. 12.
    Cruite I, Santillan C, Mamidipalli A, et al. (2016) Liver imaging reporting and data system: review of ancillary imaging features. Semin Roentgenol 51:301–307CrossRefPubMedGoogle Scholar
  13. 13.
    Chernyak V, Tang A, Flusberg M, et al. (2017) LI-RADS(R) ancillary features on CT and MRI. Abdom Radiol (NY). Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Claude B. Sirlin
    • 1
    Email author
  • Ania Z. Kielar
    • 2
    • 3
  • An Tang
    • 4
    • 5
  • Mustafa R Bashir
    • 6
    • 7
  1. 1.Liver Imaging Group, Department of RadiologyUniversity of California – San DiegoSan DiegoUSA
  2. 2.University of OttawaOttawaCanada
  3. 3.University of TorontoTorontoCanada
  4. 4.Department of RadiologyRadio-oncology and Nuclear Medicine, Centre hospitalier de l’Université de Montréal (CHUM)MontrealCanada
  5. 5.Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM)MontrealCanada
  6. 6.Department of RadiologyDuke University Medical CenterDurhamUSA
  7. 7.Center for Advanced Magnetic Resonance Development, Duke University Medical CenterDurhamUSA

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