LI-RADS

Liver · CT / MRI (HCC risk)

Liver Imaging Reporting and Data System for patients at risk of hepatocellular carcinoma.

Categories & management

CategoryMeaningMalignancyManagement
LR-1Definitely benignReturn to routine surveillance (e.g., cyst, hemangioma).
LR-2Probably benignContinue surveillance; consider follow-up in ≤6 months.
LR-3Intermediate probability of HCCRepeat or alternative imaging in 3–6 months; multidisciplinary discussion.
LR-4Probably HCCMultidisciplinary discussion; consider biopsy or treatment.
LR-5Definitely HCCHCCDiagnostic of HCC — treat as HCC without biopsy per guidelines.
LR-MProbably/definitely malignant, not HCC-specificBiopsy usually required to characterize (e.g., iCCA).
LR-TIVTumor in veinMalignant vascular invasion — multidisciplinary management.

Reference: ACR LI-RADS v2018 (CT/MRI).. Decision support only — confirm against current ACR documents and apply clinical judgment.