White paper of the Society of Abdominal Radiology hepatocellular carcinoma diagnosis disease-focused panel on LI-RADS v2018 for CT and MRI

Khaled M Elsayes; Ania Z Kielar; Mohab M Elmohr; Victoria Chernyak; William R Masch; Alessandro Furlan; Robert M Marks; Irene Cruite; Kathryn J Fowler; An Tang; Mustafa R Bashir; Elizabeth M Hecht; Aya Kamaya; Kedar Jambhekar; Amita Kamath; Sandeep Arora; Bijan Bijan; Ryan Ash; Zahra Kassam; Humaira Chaudhry; John P McGahan; Joseph H Yacoub; Matthew McInnes; Alice W Fung; Krishna Shanbhogue; James Lee; Sandeep Deshmukh; Natally Horvat; Donald G Mitchell; Richard K G Do; Venkateswar R Surabhi; Janio Szklaruk; Claude B Sirlin

doi:10.1007/s00261-018-1744-4

White paper of the Society of Abdominal Radiology hepatocellular carcinoma diagnosis disease-focused panel on LI-RADS v2018 for CT and MRI

Abdom Radiol (NY). 2018 Oct;43(10):2625-2642. doi: 10.1007/s00261-018-1744-4.

Authors

Khaled M Elsayes¹, Ania Z Kielar², Mohab M Elmohr³, Victoria Chernyak⁴, William R Masch⁵, Alessandro Furlan⁶, Robert M Marks⁷, Irene Cruite⁸, Kathryn J Fowler⁹, An Tang¹⁰, Mustafa R Bashir¹¹, Elizabeth M Hecht¹², Aya Kamaya¹³, Kedar Jambhekar¹⁴, Amita Kamath¹⁵, Sandeep Arora¹⁶, Bijan Bijan¹⁷, Ryan Ash¹⁸, Zahra Kassam¹⁹, Humaira Chaudhry²⁰, John P McGahan¹⁷, Joseph H Yacoub²¹, Matthew McInnes²², Alice W Fung²³, Krishna Shanbhogue²⁴, James Lee²⁵, Sandeep Deshmukh²⁶, Natally Horvat²⁷, Donald G Mitchell²⁶, Richard K G Do²⁸, Venkateswar R Surabhi²⁹, Janio Szklaruk³, Claude B Sirlin⁹

Affiliations

¹ Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA. kmelsayes@mdanderson.org.
² Department of Radiology, University of Toronto, Toronto, ON, Canada.
³ Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
⁴ Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
⁵ Department of Radiology, Michigan Medicine, Ann Arbor, MI, USA.
⁶ Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA.
⁷ Department of Radiology, Naval Medical Center San Diego, Uniformed Services University of the Health Sciences, San Diego, CA, USA.
⁸ Department of Radiology, Inland Imaging, Spokane, WA, USA.
⁹ Department of Radiology, University of California San Diego, San Diego, CA, USA.
¹⁰ Department of Radiology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
¹¹ Department of Radiology, Duke University Medical Center, Durham, NC, USA.
¹² Department of Radiology, Columbia University Medical Center, New York, NY, USA.
¹³ Department of Radiology, Stanford University Medical Center, Stanford, CA, USA.
¹⁴ Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
¹⁵ Department of Radiology, Mount Sinai Health System, New York, NY, USA.
¹⁶ Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
¹⁷ Department of Radiology, University of California Davis Medical Center, Sacramento, CA, USA.
¹⁸ Department of Radiology, University of Kansas, Kansas City, KS, USA.
¹⁹ Department of Diagnostic Imaging and Oncology, Schulich School of Medicine, London, ON, Canada.
²⁰ Department of Radiology, Rutgers-New Jersey Medical School, Newark, NJ, USA.
²¹ Department of Radiology, Georgetown University School of Medicine, Washington, DC, USA.
²² Department of Radiology, University of Ottawa, Ottawa, ON, Canada.
²³ Department of Radiology, Oregon Health and Science University, Portland, OR, USA.
²⁴ Department of Radiology, NYU Langone School of Medicine, New York, NY, USA.
²⁵ Department of Radiology, University of Kentucky, Lexington, KY, USA.
²⁶ Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA.
²⁷ Department of Radiology, Hospital Sirio-Libanes and University of Sao Paulo, Sao Paulo, Brazil.
²⁸ Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
²⁹ Department of Radiology, University of Texas HSC at Houston, Houston, TX, USA.

PMID: 30155697
DOI: 10.1007/s00261-018-1744-4

Abstract

The Liver Imaging and Reporting Data System (LI-RADS) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver imaging with the overarching goal of improving communication, clinical care, education, and research relating to patients at risk for or diagnosed with hepatocellular carcinoma (HCC). In 2018, the American Association for the Study of Liver Diseases (AASLD) integrated LI-RADS into its clinical practice guidance for the imaging-based diagnosis of HCC. The harmonization between the AASLD and LI-RADS diagnostic imaging criteria required minor modifications to the recently released LI-RADS v2017 guidelines, necessitating a LI-RADS v2018 update. This article provides an overview of the key changes included in LI-RADS v2018 as well as a look at the LI-RADS v2018 diagnostic algorithm and criteria, technical recommendations, and management suggestions. Substantive changes in LI-RADS v2018 are the removal of the requirement for visibility on antecedent surveillance ultrasound for LI-RADS 5 (LR-5) categorization of 10-19 mm observations with nonrim arterial phase hyper-enhancement and nonperipheral "washout", and adoption of the Organ Procurement and Transplantation Network definition of threshold growth (≥ 50% size increase of a mass in ≤ 6 months). Nomenclatural changes in LI-RADS v2018 are the removal of -us and -g as LR-5 qualifiers.

Keywords: CT; HCC; LI-RADS; MRI; v2018.

MeSH terms

Algorithms
Carcinoma, Hepatocellular / diagnostic imaging*
Diagnosis, Differential
Humans
Liver Neoplasms / diagnostic imaging*
Magnetic Resonance Imaging / standards*
Societies, Medical
Tomography, X-Ray Computed / standards*
United States