LI-RADS plans makeover for liver cancer diagnoses

The American College of Radiology's routine announcement about a new committee for liver imaging reporting is the starting point for an ambitious plan to reinvent how radiologists diagnose and evaluate hepatocellular carcinoma.

The Liver Imaging Reporting and Data System (LI-RADS) addresses frequent complaints from referring physicians about inconsistencies in the interpretation of MR and CT for HCC, according to Dr. Claude Sirlin, LI-RADS committee chair.

The ACR LI-RADS program was announced in October 2009 to discourage other, independent efforts to address the HCC lexicon program, Sirlin said.

Radiologists should not expect to see the LI-RADS lexicon until at least late 2010. Its volunteer committees need time to design and test major components, including:

• a lexicon of terms to describe number, size, shape, and location of hepatic lesions;
• a standard reporting format for MRI and CT; and
• a standardized method for estimating the probability of malignancy based on a lesion’s imaging features.

In the long run, standardization will permit the ACR or other designated groups to download individual reports into a computerized national registry of multi-institutional HCC image reporting experience, Sirlin said. Database evaluations could eventually be used to assess the effect of image interpretation on clinical decision-making and patient outcomes.