lirads_166The Liver Imaging Reporting and Data System (LI-RADS) was created to standardize the reporting and data collection of CT and MR imaging for hepatocellular carcinoma (HCC). This method of categorizing liver findings for patients with cirrhosis or other risk factors for developing HCC allows the radiology community to:


  • Apply consistent terminology
  • Reduce imaging interpretation variability and errors
  • Enhance communication with referring clinicians
  • Facilitate quality assurance and research

Please click here to view the complete LI-RADS algorithm, Atlas, and Lexicon »


 click image to view full size

LI-RADS v2014 features several enhancements:

  • Updated algorithmic display
    • Simplified algorithm
      • Removal of unnecessary decision nodes
      • Deleted A and B designation in Categories LR-4 and LR-5 
    • Treated observations are identified at the beginning of the algorithm, more reflective of radiologist thought process
    • Major features are listed in a separate box from the remainder of the table to improve clarity
  • Expanded and refined LI-RADS lexicon
  • Expanded illustrative atlas
  • New material on hepatobiliary agents, imaging technique, management and reporting, including reporting templates for CT  and MR
  • New flash cards for quick reference
  • Simplified tie-breaking rules to guide assignment of final LI-RADS category
  • Expanded background material comparing LI-RADS with AASLD and OPTN

LI-RADS v2014 also includes a key modification to achieve congruency between LR-5 and OPTN Class 5 and AASLD:

  • 10-19mm observations with arterial phase hyper-enhancement and one major feature can sometimes be categorized as LR-5 rather than LR-4
    • Observations with washout appearance and visibility on antecedent surveillance ultrasound meet criteria for HCC using AASLD criteria. These observations can be categorized as LR-5us.
    • Observations with ≥ 50% diameter increase in ≤ 6 months meet criteria for OPTN 5A-g HCC. These observations can be categorized as LR-5g.