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Guideline Current ACR 2018

LI-RADS CT/MRI v2018

Liver Imaging Reporting and Data System for HCC risk stratification in patients at risk. Categories LR-1 (definitely benign) through LR-5 (definitely HCC), plus LR-M (probably malignant, not specific for HCC), LR-TIV (tumor in vein), and LR-TR treatment-response for locoregionally treated observations.

Structured reportUpdated Jul 5, 2026
Applies to
  • Adults at high risk for hepatocellular carcinoma
  • Cirrhosis, chronic HBV, or prior HCC
  • Multiphase contrast-enhanced CT or MRI
Classification
  • LI-RADS LR-1
  • LI-RADS LR-2
  • LI-RADS LR-3
  • LI-RADS LR-4
  • LI-RADS LR-5
  • LI-RADS LR-M
  • LI-RADS LR-TIV
Exclusions
  • Patients without chronic liver disease risk factors
  • Pediatric patients
  • Post-transplant liver (use LI-RADS treatment response separately)
Interactive

Decision tree

Enter a finding to compute a recommendation without leaving the page.

Recommendation builder

Select the LI-RADS category assigned to the observation in an at-risk patient.

Evidence

References

  1. PrimaryChernyak V, et al. LI-RADS Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients. Radiology. 2018;289(3):816-830.
FAQ

Frequently asked

Does this guideline apply to oncology patients?

No — patients with known malignancy fall outside the scope unless the guideline states otherwise. Follow oncologic surveillance protocols instead.