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Abdominal Radiology

, Volume 43, Issue 10, pp 2625–2642 | Cite as

White paper of the Society of Abdominal Radiology hepatocellular carcinoma diagnosis disease-focused panel on LI-RADS v2018 for CT and MRI

  • Khaled M. Elsayes
  • Ania Z. Kielar
  • Mohab M. Elmohr
  • Victoria Chernyak
  • William R. Masch
  • Alessandro Furlan
  • Robert M. Marks
  • Irene Cruite
  • Kathryn J. Fowler
  • An Tang
  • Mustafa R. Bashir
  • Elizabeth M. Hecht
  • Aya Kamaya
  • Kedar Jambhekar
  • Amita Kamath
  • Sandeep Arora
  • Bijan Bijan
  • Ryan Ash
  • Zahra Kassam
  • Humaira Chaudhry
  • John P. McGahan
  • Joseph H. Yacoub
  • Matthew McInnes
  • Alice W. Fung
  • Krishna Shanbhogue
  • James Lee
  • Sandeep Deshmukh
  • Natally Horvat
  • Donald G. Mitchell
  • Richard K. G. Do
  • Venkateswar R. Surabhi
  • Janio Szklaruk
  • Claude B. Sirlin
Perspective

Abstract

The Liver Imaging and Reporting Data System (LI-RADS) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver imaging with the overarching goal of improving communication, clinical care, education, and research relating to patients at risk for or diagnosed with hepatocellular carcinoma (HCC). In 2018, the American Association for the Study of Liver Diseases (AASLD) integrated LI-RADS into its clinical practice guidance for the imaging-based diagnosis of HCC. The harmonization between the AASLD and LI-RADS diagnostic imaging criteria required minor modifications to the recently released LI-RADS v2017 guidelines, necessitating a LI-RADS v2018 update. This article provides an overview of the key changes included in LI-RADS v2018 as well as a look at the LI-RADS v2018 diagnostic algorithm and criteria, technical recommendations, and management suggestions. Substantive changes in LI-RADS v2018 are the removal of the requirement for visibility on antecedent surveillance ultrasound for LI-RADS 5 (LR-5) categorization of 10-19 mm observations with nonrim arterial phase hyper-enhancement and nonperipheral “washout”, and adoption of the Organ Procurement and Transplantation Network definition of threshold growth (≥ 50% size increase of a mass in ≤ 6 months). Nomenclatural changes in LI-RADS v2018 are the removal of -us and -g as LR-5 qualifiers.

Keywords

LI-RADS v2018 CT MRI HCC 

Notes

Acknowledgements

The author(s) are military service members. This work was prepared as part of official duties. Title 17 U.S.C. 105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.’

Disclaimer

The views expressed in this presentation are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Torre Lindsey A, et al. (2015) Global cancer statistics, 2012. CA A Cancer J Clin 65(2):87–108CrossRefGoogle Scholar
  2. 2.
    Wong MCS, et al. (2017) International incidence and mortality trends of liver cancer: a global profile. Sci Rep 7:45846CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Nishikawa H, Osaki Y (2015) Liver cirrhosis: evaluation, nutritional status, and prognosis. Mediat Inflamm 2015:872152CrossRefGoogle Scholar
  4. 4.
    Ferlay J, et al. (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127(12):2893–2917CrossRefPubMedGoogle Scholar
  5. 5.
    Beasley RP, et al. (1981) Hepatocellular carcinoma and hepatitis B virus: a prospective study of 22 707 men in Taiwan. The Lancet 318(8256):1129–1133CrossRefGoogle Scholar
  6. 6.
    Dhir M, et al. (2012) Comparison of outcomes of transplantation and resection in patients with early hepatocellular carcinoma: a meta-analysis. HPB 14(9):635–645CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Song DS, Bae SH (2012) Changes of guidelines diagnosing hepatocellular carcinoma during the last ten-year period. Clin Mol Hepatol 18(3):258–267CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Ganeshan D, et al. (2018) Structured reporting in radiology. Acad Radiol 25(1):66–73CrossRefPubMedGoogle Scholar
  9. 9.
    European Society of R (2018) ESR paper on structured reporting in radiology. Insights Imaging 9(1):1–7CrossRefGoogle Scholar
  10. 10.
    America RSON (2018) Radiological Society of North America radiology reporting initiative. https://www.rsna.org/Reporting_Initiative.aspx. Accessed 1 July 2018
  11. 11.
    Enterprise ITH (2018) Management of radiology report templates (MRRT). https://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_Suppl_MRRT.pdf. Accessed 28 July 2018
  12. 12.
    American College of Radiology (2017) CT/MRI LI-RADS v2017 core. https://www.acr.org/-/media/ACR/Files/RADS/LI-RADS/LIRADS_2017_Core.pdf
  13. 13.
    American College of Radiology (2013) LI-RADS v2013.1. https://www.acr.org/-/media/ACR/Files/RADS/LI-RADS/LIRADSv2013.pdf?la=en
  14. 14.
  15. 15.
    American College of Radiology (2011) LI-RADS Version 1.0. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS/LI-RADS1
  16. 16.
    Grimm LJ, et al. (2015) Interobserver variability between breast imagers using the fifth edition of the BI-RADS MRI Lexicon. AJR 204(5):1120–1124CrossRefPubMedGoogle Scholar
  17. 17.
    Mahoney MC, et al. (2012) Positive predictive value of BI-RADS MR imaging. Radiology 264(1):51–58CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Barth BK, et al. (2016) Reliability, validity, and reader acceptance of LI-RADS-An in-depth analysis. Acad Radiol 23(9):1145–1153CrossRefPubMedGoogle Scholar
  19. 19.
    American College of Radiology (2018) CT/MRI LI-RADS v2018 coreGoogle Scholar
  20. 20.
    Chernyak V, et al. (2018) LI-RADS((R)) ancillary features on CT and MRI. Abdom Radiol 43(1):82–100CrossRefGoogle Scholar
  21. 21.
    Vilgrain V, et al. (1999) Hepatic nodules in Budd-Chiari syndrome: imaging features. Radiology 210(2):443–450CrossRefPubMedGoogle Scholar
  22. 22.
    Santillan C, Chernyak V, Sirlin C (2018) LI-RADS categories: concepts, definitions, and criteria. Abdom Radiol 43(1):101–110CrossRefGoogle Scholar
  23. 23.
    van der Pol CB, LC, Bashir MR, Sirlin CB, McGrath TA, Salameh JP, Singal AG, Tang A, Fowler K, Costa A, McInnes MDF (2018) What is the percentage of hepatocellular carcinoma and overall malignancy within each LI-RADS category? A systematic review. ILCA 2018: 12th annual conference of the international liver cancer associationGoogle Scholar
  24. 24.
    Fowler KJ, et al. (2018) LI-RADS M (LR-M): definite or probable malignancy, not specific for hepatocellular carcinoma. Abdom Radiol 43(1):149–157CrossRefGoogle Scholar
  25. 25.
    Kambadakone AR, et al. (2018) LI-RADS technical requirements for CT, MRI, and contrast-enhanced ultrasound. Abdom Radiol 43(1):56–74CrossRefGoogle Scholar
  26. 26.
    Sun H, Song T (2015) Hepatocellular carcinoma: advances in diagnostic imaging. Drug Discov Ther 9(5):310–318CrossRefPubMedGoogle Scholar
  27. 27.
    Choi J-Y, Lee J-M, Sirlin CB (2014) CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part II. Extracellular agents, hepatobiliary agents, and ancillary imaging features. Radiology 273(1):30–50CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Marin D, et al. (2015) CT appearance of hepatocellular carcinoma after locoregional treatments: a comprehensive review. Gastroenterol Res Pract 2015:670965CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Kielar A, et al. (2018) Locoregional therapies for hepatocellular carcinoma and the new LI-RADS treatment response algorithm. Abdom Radiol 43(1):218–230CrossRefGoogle Scholar
  30. 30.
    Nakamura Y, et al. (2011) Clinical significance of the transitional phase at gadoxetate disodium-enhanced hepatic MRI for the diagnosis of hepatocellular carcinoma: preliminary results. J Comput Assist Tomogr 35(6):723–727CrossRefPubMedGoogle Scholar
  31. 31.
    Santillan C, et al. (2018) LI-RADS major features: CT, MRI with extracellular agents, and MRI with hepatobiliary agents. Abdom Radiol 43(1):75–81CrossRefGoogle Scholar
  32. 32.
    Wald C, et al. (2013) New OPTN/UNOS policy for liver transplant allocation: standardization of liver imaging, diagnosis, classification, and reporting of hepatocellular carcinoma. Radiology 266(2):376–382CrossRefPubMedGoogle Scholar
  33. 33.
    Heimbach JK, et al. (2018) AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 67(1):358–380CrossRefPubMedGoogle Scholar

Copyright information

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

Authors and Affiliations

  • Khaled M. Elsayes
    • 1
  • Ania Z. Kielar
    • 2
  • Mohab M. Elmohr
    • 1
  • Victoria Chernyak
    • 3
  • William R. Masch
    • 4
  • Alessandro Furlan
    • 5
  • Robert M. Marks
    • 6
  • Irene Cruite
    • 7
  • Kathryn J. Fowler
    • 8
  • An Tang
    • 9
  • Mustafa R. Bashir
    • 10
  • Elizabeth M. Hecht
    • 11
  • Aya Kamaya
    • 12
  • Kedar Jambhekar
    • 13
  • Amita Kamath
    • 14
  • Sandeep Arora
    • 15
  • Bijan Bijan
    • 16
  • Ryan Ash
    • 17
  • Zahra Kassam
    • 18
  • Humaira Chaudhry
    • 19
  • John P. McGahan
    • 16
  • Joseph H. Yacoub
    • 20
  • Matthew McInnes
    • 21
  • Alice W. Fung
    • 22
  • Krishna Shanbhogue
    • 23
  • James Lee
    • 24
  • Sandeep Deshmukh
    • 25
  • Natally Horvat
    • 26
  • Donald G. Mitchell
    • 25
  • Richard K. G. Do
    • 27
  • Venkateswar R. Surabhi
    • 28
  • Janio Szklaruk
    • 1
  • Claude B. Sirlin
    • 8
  1. 1.Department of Diagnostic RadiologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of RadiologyUniversity of TorontoTorontoCanada
  3. 3.Department of RadiologyMontefiore Medical CenterBronxUSA
  4. 4.Department of RadiologyMichigan MedicineAnn ArborUSA
  5. 5.Department of RadiologyUniversity of PittsburghPittsburghUSA
  6. 6.Department of Radiology, Naval Medical Center San DiegoUniformed Services University of the Health SciencesSan DiegoUSA
  7. 7.Department of RadiologyInland ImagingSpokaneUSA
  8. 8.Department of RadiologyUniversity of California San DiegoSan DiegoUSA
  9. 9.Department of RadiologyCentre hospitalier de l’Université de MontréalMontrealCanada
  10. 10.Department of RadiologyDuke University Medical CenterDurhamUSA
  11. 11.Department of RadiologyColumbia University Medical CenterNew YorkUSA
  12. 12.Department of RadiologyStanford University Medical CenterStanfordUSA
  13. 13.Department of RadiologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  14. 14.Department of RadiologyMount Sinai Health SystemNew YorkUSA
  15. 15.Department of Radiology and Radiological SciencesVanderbilt University Medical CenterNashvilleUSA
  16. 16.Department of RadiologyUniversity of California Davis Medical CenterSacramentoUSA
  17. 17.Department of RadiologyUniversity of KansasKansas CityUSA
  18. 18.Department of Diagnostic Imaging and OncologySchulich School of MedicineLondonCanada
  19. 19.Department of RadiologyRutgers-New Jersey Medical SchoolNewarkUSA
  20. 20.Department of RadiologyGeorgetown University School of MedicineWashingtonUSA
  21. 21.Department of RadiologyUniversity of OttawaOttawaCanada
  22. 22.Department of RadiologyOregon Health and Science UniversityPortlandUSA
  23. 23.Department of RadiologyNYU Langone School of MedicineNew YorkUSA
  24. 24.Department of RadiologyUniversity of KentuckyLexingtonUSA
  25. 25.Department of RadiologyThomas Jefferson UniversityPhiladelphiaUSA
  26. 26.Department of RadiologyHospital Sirio-Libanes and University of Sao PauloSao PauloBrazil
  27. 27.Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  28. 28.Department of RadiologyUniversity of Texas HSC at HoustonHoustonUSA

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