LI-RADS
ACR / AASLD · v2018 CT/MRI · Updated v2018 CT/MRI
Standardized diagnosis and reporting of HCC in at-risk patients. Major features, ancillary features, and LR-1 through LR-5, LR-M, LR-TIV categories.
LR-5 = definitive HCC without biopsy in the appropriate at-risk population.
At-risk patients for HCC (cirrhosis, chronic HBV, current or prior HCC) · Multiphase contrast-enhanced CT or MRI (extracellular or hepatobiliary agents)
Patients without HCC risk factors · Vascular tumors in a non-cirrhotic liver · Pediatric patients
CT / MRI
ACR / AASLD consensus
Categorize each observation LR-1 (benign) through LR-5 (definite HCC), plus LR-M (malignant, not specifically HCC) and LR-TIV (tumor-in-vein). Major features: size, arterial-phase hyperenhancement, washout, capsule, threshold growth.
Overview
CT/MRI LI-RADS assigns an ordinal category to every liver observation in at-risk patients using major and ancillary features. LR-5 is definitive HCC in the appropriate patient without pathologic confirmation. LR-M and LR-TIV recognize non-HCC malignancies and macrovascular invasion.
Quick reference
| Category | Meaning |
|---|---|
| LR-1 | Definitely benign |
| LR-2 | Probably benign |
| LR-3 | Intermediate probability of HCC |
| LR-4 | Probably HCC |
| LR-5 | Definitely HCC — no biopsy required |
| LR-M | Malignant, not specific for HCC |
| LR-TIV | Tumor in vein |
Structured report
Interactive template that produces a validated dictation ready for the report.
References
- OpenACR CT/MRI LI-RADS v2018