Transplant-oriented

Multifocal HCC · LI-RADS + TRA v2024 — Milan/UNOS Transplant Criteria

Structured reporting for diagnosis, treatment response assessment, and transplant eligibility in hepatocellular carcinoma. Milan, UNOS T2, downstaging, UCSF, and Up-to-7 evaluated automatically.

Transplant eligibility
Beyond Milan
UNOS T2: Not eligible
Downstaging: Not eligible
Highest LI-RADS
LR-5 lesions
0
Largest
Sum viable
Milan
Beyond
UNOS T2
Not eligible
Downstaging
Not eligible
Macrovascular
Absent
Extrahepatic
Absent
Child-Pugh
MELD-Na
22
AFP

LI-RADS applies only to patients at high risk for HCC.

Indication
HCC risk category
Etiology
ECOG performance status

ECOG 0 fully active · 1 mild limitation · ≥2 may influence treatment candidacy

Auto-calculates Child-Pugh, MELD-Na, and AFP category.

AFP (ng/mL)
Bilirubin (mg/dL)
Albumin (g/dL)
INR
Platelets (×10³)
Sodium (mmol/L)
Creatinine (mg/dL)
Ascites (Child-Pugh)
Encephalopathy
Portal hypertension evidence

Clinically significant portal hypertension absent.

Treatments received
Modality
Contrast agent
Technical adequacy
Cirrhosis
Steatosis
Iron overload
Ascites
PV cavernous transformation
Portosystemic shunts

Add unlimited lesions. LI-RADS category auto-derives from major features.

Segment
Size (mm)
Nonrim APHE
Nonperipheral washout
Enhancing capsule
Threshold growth
Ancillary features favoring HCC
Ancillary favoring benignity
LR-M features (targetoid / infiltrative)
Total lesions
0
LR-5 lesions
0
Largest
Sum viable
All vessels patentEdit
Main PV
Right PV
Left PV
Hepatic veins
SMV
IVC
Hepatic artery
Lymphadenopathy
Lung metastases
Peritoneal
Bone
Adrenal
Other metastases
Milan criteria
Not eligible / Not met

Single ≤5 cm OR up to 3 lesions each ≤3 cm; no macrovascular invasion or extrahepatic disease.

UNOS T2 status
Not eligible / Not met
  • Beyond Milan criteria.

Aligned with Milan; AFP ≤1000 ng/mL required for listing.

UNOS downstaging
Not eligible / Not met
  • Tumor burden (n=0, largest 0.0 cm, sum 0.0 cm) exceeds UNOS downstaging criteria.

1 lesion 5–8 cm · 2–3 lesions each ≤5 cm (sum ≤8 cm) · 4–5 lesions each ≤3 cm (sum ≤8 cm).

UCSF · Up-to-7
Eligible / Met
  • UCSF: Not met.
  • Up-to-7: Met (score 0.0).

Extended reference criteria.

Waitlist status

Auto-derived from lesion burden, vascular, hepatic reserve, and prior therapy data above.

Ablation eligibility
Insufficient data

Complete lesion size and burden data to assess.

Why?
  • Largest lesion — (ideal ≤3 cm; up to 4 cm acceptable).
  • 0 lesions (favor ≤3 lesions).
  • Macrovascular invasion: absent.
  • Extrahepatic disease: absent.
TACE eligibility
Insufficient data

Complete lesion, vascular, and Child-Pugh data to assess.

Why?
  • Macrovascular invasion: absent.
  • Extrahepatic disease: absent.
  • Bilirubin 0.0 mg/dL (caution if >2, avoid if >3).
  • Tumor burden: 0 lesions, largest —.
Y90 radioembolization suitability
Insufficient data

Complete vascular, hepatic reserve, and burden data to assess.

Why?
  • Macrovascular invasion: absent.
  • Extrahepatic disease: absent.
  • Bilirubin 0.0 mg/dL (avoid Y90 if >2 without segmental targeting).
  • Tumor burden: 0 lesions, largest —.
Systemic therapy considerations
Insufficient data

Complete stage, hepatic reserve, and performance data to assess.

Why?
  • Macrovascular invasion: absent.
  • Extrahepatic disease: absent.
Treatment eligibility summary
  • • Ablation: Insufficient data
  • • TACE: Insufficient data
  • • Y90: Insufficient data
  • • Systemic therapy: Insufficient data
Suggested management pathway: Complete lesion characterization to generate a suggested pathway.
Final impression banner

Solitary hepatic observation with tumor burden beyond Milan and downstaging criteria, without macrovascular invasion or extrahepatic disease.

Auto-generated impression
• Macrovascular invasion absent; extrahepatic disease absent.
• No measurable hepatic observations characterized.
• MELD-Na 22.
Recommended next steps
  • Complete lesion characterization to generate recommendations.