The Liver Imaging Reporting and Data Systems (LI-RADS) treatment response algorithm following locoregional therapy

The LI-RADS treatment response algorithm is used to predict the viability of HCC after locoregional treatment (eg, ablation, embolization). It is not appropriate to assess response after systemic therapy. https://www.acr.org/-/media/ACR/Files/RADS/LI-RADS/LI-RADS-2018-Core.pdf?la=en.

MRI: magnetic resonance imaging; LR-TR: LI-RADS treatment response; HCC: hepatocellular cancer.
* Images may be inevaluable due to image degradation, poor contrast bolus, or lack of multiphasic imaging.
¶ Viability criteria include nodular, masslike, or thick irregular tissue in or along the treated lesion with arterial phase contrast hyperenhancement OR washout on portal venous phase OR enhancement similar to pretreatment.
Δ The criteria for LR-TR nonviable include no lesional enhancement OR treatment-specific expected enhancement patterns (eg, peripheral rim enhancement).

Adapted by permission from: Springer: Abdominal Radiology. Kielar A, Fowler KJ, Lewis S, et al. Locoregional therapies for hepatocellular carcinoma and the new LI-RADS treatment response algorithm. Abdom Radiol (NY) 2018; 43:218. Copyright © 2018. https://www.springer.com/journal/261.

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The Liver Imaging Reporting and Data Systems (LI-RADS) treatment response algorithm following locoregional therapy