Liver Imaging Report (LI-RADS)

Exam Type/Modality: [CT / MRI / US; note if multiphase for CT/MRI]

LI-RADS Algorithm: [CT/MRI Diagnostic v2018 / US Surveillance v2024 / CT/MRI TRA v2024; specify radiation vs nonradiation TRA if applicable]

Comparison: [prior exam dates and modalities, or "None available"]

Clinical History

[Ordering indication: surveillance / diagnostic evaluation / post-treatment assessment / transplant evaluation]. [LI-RADS population eligibility basis: cirrhosis with etiology / chronic hepatitis B / current or prior HCC / post-transplant status]. [Prior HCC treatments with type and approximate date, if applicable]. [Relevant labs or clinical context, if provided]. (If eligibility is unknown, state that LI-RADS categories are provisional pending confirmation of risk status.)

Technique

CT/MRI: [Contrast agent]. [Phases acquired: late arterial, portal venous, delayed]. [Technical adequacy: arterial phase timing, artifacts affecting evaluation]. (If technically inadequate for LI-RADS categorization, state explicitly and note which major features cannot be assessed.)

US: [Surveillance context]. [Visualization limitations]. (Include only if US examination.)

Findings

Liver background: [Cirrhotic morphology: present / absent]. [Portal hypertension features]. [Vascular patency: portal vein, hepatic veins]. [Other relevant background findings].

Untreated Observations (CT/MRI Diagnostic)

(Include only if using CT/MRI Diagnostic LI-RADS. Treat equivocal major features as absent for categorization.)

Observation [#] — Segment [#]. [Size in mm] ([measurement phase/sequence]).

• Nonrim APHE: [present / absent / equivocal]
• Nonperipheral washout: [present / absent / equivocal; specify phase]
• Enhancing capsule: [present / absent / equivocal]
• Threshold growth: [present / absent; prior size and date if applicable]
• LI-RADS category: [LR-1 / LR-2 / LR-3 / LR-4 / LR-5 / LR-M / LR-NC / LR-TIV]
• Change from prior: [new / stable / increased / decreased]
• (For LR-M: note targetoid appearance and likely etiology. For LR-TIV: specify vessel and likely etiology.)

(Repeat for each observation. Aggregate numerous LR-1/LR-2 observations with count and category range.)

Treated Observations (CT/MRI TRA)

(Include only if treated lesions present; omit section entirely otherwise.)

Treated Observation [#] — Segment [#]. [Treatment type and date].

• TRA category: [Nonevaluable / Nonviable / Equivocal / Viable; add Nonprogressing for radiation-treated lesions]
• Enhancing component: [size in mm if viable/equivocal]
• Change from prior: [decreased / stable / increased]

(Repeat for each treated observation.)

US Surveillance Observations

(Include only if US Surveillance; US category and visualization score belong in Impression.)

Observation [#]: [Location] — [Size in mm]. [Pertinent sonographic features].

Other findings: [Clinically significant extrahepatic findings]. (Omit if none.)

Impression

1. Summary: [Definite HCC identified / No reportable LI-RADS observations / Post-treatment assessment performed]
2. Key observations by urgency:
   • [LR-TIV: Observation ID, segment, size, vessel involved]
   • [LR-M: Observation ID, segment, size, targetoid appearance if present]
   • [LR-5: Observation ID, segment, size, decisive major features]
   • [LR-4: Observation ID, segment, size, decisive features]
   • [LR-3 and treated lesions: identifiers and key features]
   (Include only categories present on this exam.)
3. Categorical summary: [Number of LR-5 with largest size]. [LR-M present / absent]. [LR-TIV present / absent]. [TRA category counts if applicable]. (Include for staging/transplant context.)
4. US Surveillance: US category [US-1 / US-2 / US-3]. Visualization score [VIS-A / VIS-B / VIS-C]. (Include only for US Surveillance.)
5. Management recommendation: [LR-1/LR-2: return to routine surveillance / LR-3 or LR-NC: short-interval follow-up imaging / LR-4 or LR-M: multidisciplinary discussion / LR-5: manage as HCC with multidisciplinary discussion / LR-TIV: multidisciplinary discussion with etiology noted / TRA Viable: consider retreatment discussion]
6. Limitations: [Image quality or missing phases limiting sensitivity]. [Recommended next step]. (Omit if no significant limitations.)