Liver Imaging Reporting and Data System Classification of Hepatocellular Carcinoma: Implications for Clinical Management

Abstract

As the incidence of hepatocellular carcinoma (HCC) continues to increase worldwide, the role imaging plays in management continues to gain clinical importance. Multiple entry points exist for patients in the scheme of diagnosis and treatment of HCC and non-HCC malignancies. Further complicating this scheme is the lack of standardization in the language used for diagnostic imaging and management recommendations. The Liver Imaging Reporting and Data System (LI-RADS) was created to improve communication between clinicians and management teams. LI-RADS serves to standardize reports, improving physician satisfaction and aiding in management decisions across the continuum of care of these patients. Furthermore, LI-RADS provides technical specifications across multiple imaging modalities for screening and follow-up examinations, with the end goal of curing the disease or prolonging survival. In this review, the LI-RADS algorithm will be expanded upon, as well as its utility for various treatment options using the standardized LI-RADS lexicon. Additionally, pitfalls and non-HCC malignancies will also be addressed with resultant improvement in reproducibility of radiology reports that guide therapeutic management.