CT/MRI LI-RADS v2017 – review of the guidelines

Abstract

The Liver Imaging-Reporting and Data System (LI-RADS or LR) is a classification system for reading and reporting imaging studies in patients with high risk for hepatocellular carcinoma (HCC). One of its main goals is to improve communication between specialties, especially radiologists, hepatologists, surgeons, and pathologists. LI-RADS defines imaging features of the lesions and stratifies the risk of HCC into categories. It is the most comprehensive and highly specific system; however, its seeming complexity prevents many radiologists from using it in everyday practice. This article is a detailed review of the latest version of LI-RADS (v. 2017), which should be helpful for radiologists who are not very familiar with the system and its latest update.

Radiomics Analysis Based on Multiparametric MRI for Predicting Early Recurrence in Hepatocellular Carcinoma After Partial Hepatectomy

“…and reader 2, J.J.W., with 10 and 5 years of abdominal MRI interpretation, respectively). The two radiologists who were blinded to the clinicopathologic data and follow‐up information independently evaluated the following imaging traits: 1) tumor size (the maximum axial diameter of the largest lesion measured on the PVP images); 2) tumor number (one lesion or more than one lesion); 3) tumor margin (smooth or non‐smooth); 4) intratumor necrosis (defined as hypointensity on T 1 ‐weighted imaging (T 1 WI), hyperintensity on T 2 WI and no enhancement of part of the tumor on the AP, PVP, and DP images); 5) intratumor hemorrhage (defined as heterogeneous hyperintensity on T 1 WI and hypointensity on T 2 WI); 6) pseudocapsule (defined as a ring of hyperenhancement around the tumor margin on the PVP and DP images) 22 ; 7) peritumoral enhancement (defined as a zone of hyperenhancement around the tumor on the AP or PVP images) 22 ; 8) internal arteries (defined as discrete arteries within the tumor); 9) arterial phase hyperenhancement (defined as hyperenhancement of the tumor compared to the rest of the liver on the AP images); 10) washout appearance (defined as decreased enhancement of the tumor or part of it, compared to the liver parenchyma surrounding the tumor on the PVP or DP images); 11) radiologic cirrhosis (defined as surface nodularity, widening of fissures, notching of the right lobe, and enlargement of the lateral segments of the left lobe and caudate lobe) 23 . If there was any disagreement between radiologists regarding the presence or absence of the radiologic features, the images were evaluated by another senior radiologist (reader 3, J.H.L., with 15 years of abdominal MRI interpretation).…”

Radiological appearance of hepatocellular carcinoma predicts the response to trans-arterial chemoembolization in patients undergoing liver transplantation

“…The shape of the tumor margin was categorized into three subgroups: smooth; lobulated or infiltrative. Capsule appearance means a rim of hyper-enhancement in portal, delayed, or transitional phase, which is unequivocally thicker than fibrotic tissue around background nodules [18].…”

Radiological Appearance of Hepatocellular Carcinoma Predicts the Response to Trans-arterial Chemoembolization in Patients Undergoing Liver Transplantation

“…The shape of the tumor margin was categorized into three subgroups: smooth; lobulated or infiltrative. Capsule appearance means a rim of hyper-enhancement in portal, delayed, or transitional phase, which is unequivocally thicker than fibrotic tissue around background nodules [18]. CT follow-up was performed 1 month after TACE, and at least every 3 months until LT.…”