Evidence Supporting LI-RADS Major Features for CT- and MR Imaging-based Diagnosis of Hepatocellular Carcinoma: A Systematic Review.
Radiology. 2018 Jan;286(1):29-48. doi: 10.1148/radiol.2017170554. Epub 2017 Nov 21. Tang A1, Bashir MR1, Corwin MT1, Cruite I1, Dietrich CF1, Do RKG1, Ehman EC1, Fowler KJ1, Hussain HK1, Jha RC1, Karam AR1, Mamidipalli A1, Marks RM1, Mitchell DG1, Morgan TA1, Ohliger MA1, Shah A1, Vu KN1, Sirlin CB1; LI-RADS Evidence Working Group1.
The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing. Development of LI-RADS has been based on literature review, expert opinion, rounds of testing and iteration, and feedback from users. This article summarizes and assesses the quality of evidence supporting each LI-RADS major feature for diagnosis of HCC, as well as of the LI-RADS imaging features suggesting malignancy other than HCC. Based on the evidence, recommendations are provided for or against their continued inclusion in LI-RADS. © RSNA, 2017 Online supplemental material is available for this article.