CT MRI LI-RADS in Routine Practice

Primary liver cancer is the third most common cause of cancer-related deaths worldwide with hepatocellular carcinoma (HCC) comprising the vast majority of the cases. HCC unlike most solid cancers can be diagnosed based on imaging findings alone using multiphasic contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) without the need for histopathological confirmation in the majority of the cases. Liver Imaging Reporting and Data System (LI-RADS) was first introduced by the American College of Radiology in 2011 with the help of a multidisciplinary team of liver disease experts to improve the accuracy, consistency, and clarity of communication of imaging findings between radiologists and treating physicians. To date, LI-RADS has undergone four major updates in 2013, 2014, 2017, and 2018. This article reviews the technical aspects, categorization, and major and ancillary imaging features for the application of LI-RADS version 2018 using CT and MRI in routine clinical practice.