Review Articles

Contrast-Enhanced Ultrasound LI-RADS: A Pictorial Review

  • Osama Mahmoud, BS ,
  • Ajay Makkena, BS ,
  • Corinne E. Wessner, MS, MBA, RDMS ,
  • Ji-Bin Liu, MD ,
  • John R. Eisenbrey, PhD ,
  • Andrej Lyshchik, MD, PhD
Expand
  • aSidney Kimmel Medical School, Thomas Jefferson University, Philadelphia, USA
    bDepartment of Radiology, Thomas Jefferson University and Hospital, Philadelphia, USA
Department of Radiology, Thomas Jefferson University, 7th Floor Main Building, 132 S. 10th Street, Philadelphia, PA 19107, USA. e-mail: Andrej.lyshchik@jefferson.edu

Received date: 2023-06-21

  Revised date: 2023-07-21

  Accepted date: 2023-08-20

  Online published: 2023-10-23

Abstract

The American College of Radiology has implemented the Liver Imaging Reporting and Data System (LI-RADS) to help detect, interpret, and guide the management of suspected lesions on surveillance imaging for hepatocellular carcinoma (HCC) in patients with cirrhosis. The classification of indeterminate nodules with a grading algorithm can be used for multiple imaging modalities (US, CT, and MRI) and incorporates multiple imaging features to appropriately classify observations with different likelihood of being HCC. Contrast-enhanced ultrasound (CEUS) LI-RADS has been fully implemented since 2017. The aim of this pictorial article is to provide a comprehensive review of CEUS LI-RADS utilization, discuss its advantages, and highlight areas for potential improvement.

Cite this article

Osama Mahmoud, BS , Ajay Makkena, BS , Corinne E. Wessner, MS, MBA, RDMS , Ji-Bin Liu, MD , John R. Eisenbrey, PhD , Andrej Lyshchik, MD, PhD . Contrast-Enhanced Ultrasound LI-RADS: A Pictorial Review[J]. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY, 2023 , 7(4) : 321 -332 . DOI: 10.37015/AUDT.2023.230041

References

[1] Rumgay H, Arnold M, Ferlay J, Lesi O, Cabasag CJ, Vignat J, et al. Global burden of primary liver cancer in 2020 and predictions to 2040. J Hepatol 2022; 77:1598-1606.
[2] Ding J, Long L, Zhang X, Chen C, Zhou H, Zhou Y, et al. Contrast-enhanced ultrasound LI-RADS 2017: Comparison with CT/MRI LI-RADS. Eur Radiol 2021; 31:847-854.
[3] Tan Z, Teoh WC, Wong KM, Wansaicheong GK, Sandrasegaran K. Analysis of comparative performance of CEUS and CECT/MR LI-RADS classification: Can CEUS dichotomize LI-RADS indeterminate lesions on CT or MRI? Clin Imaging 2020; 62:63-68.
[4] Golabi P, Fazel S, Otgonsuren M, Sayiner M, Locklear CT, Younossi ZM. Mortality assessment of patients with hepatocellular carcinoma according to underlying disease and treatment modalities. Medicine (Baltimore) 2017; 96:e5904.
[5] Tunissiolli NM, Castanhole-Nunes MMU, Biselli-Chicote PM, Pavarino EC, da Silva RF, da Silva RC, et al. Hepatocellular carcinoma: A comprehensive review of biomarkers, clinical aspects, and therapy. Asian Pac J Cancer Prev 2017; 18:863-872.
[6] American College of Radiology. LI-RADS? CEUS v2017 | American College of Radiology. https://www.acr.org/-/media/ACR/Files/RADS/LI-RADS/CEUS-LI-RADS-2017-Core.pdf
[7] Wilson SR, Lyshchik A, Piscaglia F, Cosgrove D, Jang HJ, Sirlin C, et al. CEUS LI-RADS: algorithm, implementation, and key differences from CT/MRI. Abdom Radiol (NY) 2018; 43:127-142.
[8] Eisenbrey JR, Gabriel H, Savsani E, Lyshchik A. Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies. Abdom Radiol (NY) 2021; 46:3579-3595.
[9] Morgan TA, Maturen KE, Dahiya N, Sun MRM, Kamaya A. US LI-RADS: Ultrasound liver imaging reporting and data system for screening and surveillance of hepatocellular carcinoma. Abdom Radiol (NY) 2018; 43:41-55.
[10] Chen LD, Ruan SM, Lin Y, Liang JY, Shen SL, Hu HT, et al. Comparison between M-score and LR-M in the reporting system of contrast-enhanced ultrasound LI-RADS. Eur Radiol 2019; 29:4249-4257.
[11] Li CQ, Huang H, Ruan SM, Hu HT, Xian MF, Xie XY, et al. An assessment of liver lesions using a combination of CEUS LI-RADS and AFP. Abdom Radiol (NY) 2022; 47:1311-1320.
[12] Zheng W, Li Q, Zou XB, Wang JW, Han F, Li F, et al. Evaluation of contrast-enhanced US LI-RADS version 2017: Application on 2020 liver nodules in patients with hepatitis B infection. Radiology 2020; 294:299-307.
[13] Lyshchik A, Kono Y, Dietrich CF, Jang HJ, Kim TK, Piscaglia F, et al. Contrast-enhanced ultrasound of the liver: technical and lexicon recommendations from the ACR CEUS LI-RADS working group. Abdom Radiol (NY) 2018; 43:861-879.
[14] Hu YX, Shen JX, Han J, Mao SY, Mao RS, Li Q, et al. Diagnosis of non-hepatocellular carcinoma malignancies in patients with risks for hepatocellular carcinoma: CEUS LI-RADS Versus CT/MRI LI-RADS. Front Oncol 2021; 11:641195.
[15] Liu W, Qin J, Guo R, Xie S, Jiang H, Wang X, et al. Accuracy of the diagnostic evaluation of hepatocellular carcinoma with LI-RADS. Acta Radiol 2018; 59:140-146.
[16] Terzi E, Iavarone M, Pompili M, Veronese L, Cabibbo G, Fraquelli M, et al. Contrast ultrasound LI-RADS LR-5 identifies hepatocellular carcinoma in cirrhosis in a multicenter retrospective study of 1,006 nodules. J Hepatol 2018; 68:485-492.
[17] Bartolotta TV, Terranova MC, Gagliardo C, Taibbi A. CEUS LI-RADS: a pictorial review. Insights Imaging 2020; 11:9.
[18] Kim DH, Choi SH, Park SH, Kim KW, Byun JH, Kim SY, et al. The Liver Imaging Reporting and Data System tumor-in-vein category: A systematic review and meta-analysis. Eur Radiol 2021; 31:2497-2506.
[19] Nguyen SA, Merrill CD, Burrowes DP, Medellin GA, Wilson SR. Hepatocellular carcinoma in evolution: Correlation with CEUS LI-RADS. Radiographics 2022; 42:1028-1042.
[20] Li W, Li L, Zhuang BW, Ruan SM, Hu HT, Huang Y, et al. Inter-reader agreement of CEUS LI-RADS among radiologists with different levels of experience. European Radiology 2021; 31:6758-6767.
[21] Sugimoto K, Kakegawa T, Takahashi H, Tomita Y, Abe M, Yoshimasu Y, et al. Usefulness of modified CEUS LI-RADS for the diagnosis of hepatocellular carcinoma using Sonazoid. Diagnostics (Basel) 2020; 10:828.
[22] Schellhaas B, Hammon M, Strobel D, Pfeifer L, Kielisch C, Goertz RS, et al. Interobserver and intermodality agreement of standardized algorithms for non-invasive diagnosis of hepatocellular carcinoma in high-risk patients: CEUS-LI-RADS versus MRI-LI-RADS. Eur Radiol 2018; 28:4254-4264.
[23] Quaia E. State of the art: LI-RADS for contrast-enhanced US. Radiology 2019;293.
[24] World Health Organization. Number of new cases and deaths from liver cancer is predicted to rise by more than 55% by 2040. https://www.iarc.who.int/news-events/number-of-new-cases-and-deaths-from-liver-cancer-predicted-to-rise-by-more-than-55-by-2040/
Outlines

/