LI-RADS v2018 CT/MRI
Oncology, staging and radiology
Also known as: LI-RADS (CT/MRT, v2018) · LI-RADS v2018 · LI-RADS CT/MRI diagnostic categories (v2018)
What it is for
The Liver Imaging Reporting and Data System (LI-RADS) of the American College of Radiology categorises liver observations on multiphase CT or MRI in adults at high risk of hepatocellular carcinoma (HCC), e.g. cirrhosis or chronic hepatitis B; it is not applied in patients under 18 or in cirrhosis from congenital hepatic fibrosis or vascular disorders.
Classification
| Category | Description |
|---|---|
| LR-NC | not categorisable because images are degraded or omitted. |
| LR-1 | definitely benign. |
| LR-2 | probably benign. |
| LR-3 | intermediate probability of HCC. |
| LR-4 | probably HCC. |
| LR-5 | definitely HCC; requires non-rim arterial phase hyperenhancement (APHE) and size ≥10 mm plus further major features (e.g. 10–19 mm with non-peripheral 'washout', or ≥20 mm with one of washout, enhancing 'capsule' or threshold growth). |
| LR-M | probably or definitely malignant, not specific for HCC (e.g. targetoid mass, rim APHE, infiltrative appearance, marked diffusion restriction, necrosis). |
| LR-TIV | tumour in vein: unequivocal enhancing soft tissue in a vein. |
| Major features | non-rim APHE, non-peripheral washout, enhancing capsule, size, threshold growth (≥50% size increase in ≤6 months). Ancillary features may shift a category by one but cannot upgrade to LR-5. |
Source
Liver Imaging Reporting and Data System (LI-RADS) Version 2018: Imaging of Hepatocellular Carcinoma in At-Risk Patients
ACR · Radiology 2018;289:816–830 (Chernyak V et al.)
DOI: 10.1148/radiol.2018181494
PMID: 30251931
- Edition
- ACR LI-RADS CT/MRI diagnostic algorithm v2018 (still current; only the treatment-response algorithm was updated in 2024)
- Checked on
Summary of the published classification in our own words. Not a substitute for the original publication.
A question about this classification?
Medelix answers clinical questions from guidelines and studies – every statement with its source.