Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
Department of Radiology, University of Toronto, Toronto, ON, Canada.
Abdom Radiol (NY). 2018 Oct;43(10):2625-2642. doi: 10.1007/s00261-018-1744-4.
The Liver Imaging and Reporting Data System (LI-RADS) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver imaging with the overarching goal of improving communication, clinical care, education, and research relating to patients at risk for or diagnosed with hepatocellular carcinoma (HCC). In 2018, the American Association for the Study of Liver Diseases (AASLD) integrated LI-RADS into its clinical practice guidance for the imaging-based diagnosis of HCC. The harmonization between the AASLD and LI-RADS diagnostic imaging criteria required minor modifications to the recently released LI-RADS v2017 guidelines, necessitating a LI-RADS v2018 update. This article provides an overview of the key changes included in LI-RADS v2018 as well as a look at the LI-RADS v2018 diagnostic algorithm and criteria, technical recommendations, and management suggestions. Substantive changes in LI-RADS v2018 are the removal of the requirement for visibility on antecedent surveillance ultrasound for LI-RADS 5 (LR-5) categorization of 10-19 mm observations with nonrim arterial phase hyper-enhancement and nonperipheral "washout", and adoption of the Organ Procurement and Transplantation Network definition of threshold growth (≥ 50% size increase of a mass in ≤ 6 months). Nomenclatural changes in LI-RADS v2018 are the removal of -us and -g as LR-5 qualifiers.
肝脏影像报告和数据系统 (LI-RADS) 是一个用于规范肝脏影像学术语、技术、解读、报告和数据收集的综合系统，其总体目标是改善与肝细胞癌 (HCC) 风险患者或确诊患者相关的沟通、临床护理、教育和研究。2018 年，美国肝病研究学会 (AASLD) 将 LI-RADS 纳入其 HCC 影像学诊断的临床实践指南。为了使 AASLD 和 LI-RADS 诊断影像学标准相协调，LI-RADS v2017 指南需要进行微小修改，因此需要进行 LI-RADS v2018 更新。本文概述了 LI-RADS v2018 中包含的主要变化，并介绍了 LI-RADS v2018 诊断算法和标准、技术建议和管理建议。LI-RADS v2018 的实质性变化包括删除了在先前监测性超声上可见的要求，用于非边缘动脉期高增强和非周边“洗脱”的 10-19mm 观察的 LR-5 分类，以及采用器官获取和移植网络对阈值生长的定义（在≤6 个月内质量增加≥50%）。LI-RADS v2018 的命名变化包括删除了-LR-5 qualifier 中的 -us 和 -g。
