Updates on LI-RADS Treatment Response Criteria for Hepatocellular Carcinoma: Focusing on MRI.

Journal of magnetic resonance imaging : JMRI 2023 Jun

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As the incidence of hepatocellular carcinoma (HCC) and subsequent treatments with liver-directed therapies rise, the complexity of assessing lesion response has also increased. The Liver Imaging Reporting and Data Systems (LI-RADS) treatment response algorithm (LI-RADS TRA) was created to standardize the assessment of response after locoregional therapy (LRT) on contrast-enhanced CT or MRI. Originally created based on expert opinion, these guidelines are currently undergoing revision based on emerging evidence. While many studies support the use of LR-TRA for evaluation of HCC response after thermal ablation and intra-arterial embolic therapy, data suggest a need for refinements to improve assessment after radiation therapy. In this manuscript, we review expected MR imaging findings after different forms of LRT, clarify how to apply the current LI-RADS TRA by type of LRT, explore emerging literature on LI-RADS TRA, and highlight future updates to the algorithm. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 2. © 2023 International Society for Magnetic Resonance in Medicine.

Citation

Richa Patel, Anum Aslam, Neehar D Parikh, Benjamin Mervak, Eman Mubarak, Lily Higgins, Kayli Lala, Jack F Conner, Valerie Khaykin, Mustafa Bashir, Richard Kinh Gian Do, Lauren M B Burke, Elainea N Smith, Charles Y Kim, Kimberly L Shampain, Dawn Owen, Mishal Mendiratta-Lala. Updates on LI-RADS Treatment Response Criteria for Hepatocellular Carcinoma: Focusing on MRI. Journal of magnetic resonance imaging : JMRI. 2023 Jun;57(6):1641-1654