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LI-RADS: a conceptual and historical review from its beginning to its recent integration into AASLD clinical practice guidance

Authors Elsayes KM, Kielar AZ, Chernyak V, Morshid A, Furlan A, Masch WR, Marks RM, Kamaya A, Do RKG, Kono Y, Fowler KJ, Tang A, Bashir MR, Hecht EM, Jambhekar K, Lyshchik A, Rodgers SK, Heiken JP, Kohli M, Fetzer DT, Wilson SR, Kassam Z, Mendiratta-Lala M, Singal AG, Lim CS, Cruite I, Lee J, Ash R, Mitchell DG, McInnes MDF, Sirlin CB

Received 3 September 2018

Accepted for publication 14 November 2018

Published 5 February 2019 Volume 2019:6 Pages 49—69

DOI https://doi.org/10.2147/JHC.S186239

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 1

Editor who approved publication: Professor Xin Wang


Khaled M Elsayes,1 Ania Z Kielar,2 Victoria Chernyak,3 Ali Morshid,1 Alessandro Furlan,4 William R Masch,5 Robert M Marks,6 Aya Kamaya,7 Richard KG Do,8 Yuko Kono,9 Kathryn J Fowler,9 An Tang,10 Mustafa R Bashir,11 Elizabeth M Hecht,12 Kedar Jambhekar,13 Andrej Lyshchik,14 Shuchi K Rodgers,14 Jay P Heiken,15 Marc Kohli,16 David T Fetzer,17 Stephanie R Wilson,18 Zahra Kassam,19 Mishal Mendiratta-Lala,5 Amit G Singal,17 Christopher S Lim,20 Irene Cruite,21 James Lee,22 Ryan Ash,23 Donald G Mitchell,14 Matthew DF McInnes,24 Claude B Sirlin9

1Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 2Department of Radiology, University of Toronto, ON, Canada; 3Department of Radiology, Montefiore Medical Center, Bronx, NY, USA; 4Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA; 5Department of Radiology, University of Michigan, Ann Arbor, MI, USA; 6Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; 7Department of Radiology, Stanford University Medical Center, Stanford, CA, USA; 8Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; 9Department of Radiology, University of California San Diego, CA, USA; 10Department of Radiology, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada; 11Department of Radiology, Center for Advanced Magnetic Resonance Development, and Division of Gastroenterology, Department of Medicine, Duke University Medical Center, Durham, NC, USA; 12Department of Radiology, Columbia University Medical Center, New York, NY, USA; 13Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 14Department of Radiology, Einstein Medical Center, Philadelphia, PA, USA; 15Department of Radiology, Mayo Clinic, Rochester, MN, USA; 16Department of Radiology, University of California San Francisco, CA, USA; 17Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, TX, USA; 18Department of Radiology, University of Calgary, Calgary, AB, Canada; 19Department of Diagnostic Imaging, Schulich School of Medicine, London, ON, Canada; 20Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, ON, Canada; 21Department of Radiology, Inland Imaging, Spokane, WA, USA; 22Department of Radiology, University of Kentucky, Lexington, KY, USA; 23Department of Radiology, University of Kansas, Kansas City, KS, USA; 24Department of Radiology, University of Ottawa, ON, Canada

Abstract: The Liver Imaging Reporting and Data System (LI-RADS®) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver observations in individuals at high risk for hepatocellular carcinoma (HCC). LI-RADS is supported and endorsed by the American College of Radiology (ACR). Upon its initial release in 2011, LI-RADS applied only to liver observations identified at CT or MRI. It has since been refined and expanded over multiple updates to now also address ultrasound-based surveillance, contrast-enhanced ultrasound for HCC diagnosis, and CT/MRI for assessing treatment response after locoregional therapy. The LI-RADS 2018 version was integrated into the HCC diagnosis, staging, and management practice guidance of the American Association for the Study of Liver Diseases (AASLD). This article reviews the major LI-RADS updates since its 2011 inception and provides an overview of the currently published LI-RADS algorithms.

Keywords: LI-RADS, v2018, CT, MRI, CEUS, US, HCC, liver imaging, reporting, cirrhosis

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