Select the target population: Patients who have a liver lesion on imaging (eg, ultrasound) and who are at risk for HCC due to at least one of the following:
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Perform one of the following studies, tailored for liver lesion evaluation:¶
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Categorize lesion(s) using LI-RADS | |||
LI-RADS categorization of liver lesions in patients at risk for hepatocellular carcinoma | |||
Category | Assessment | Diagnostic considerations | Action |
LR-1 | Definitely benign | Includes hemangiomas with characteristic features or cysts. |
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LR-2 | Probably benign | Includes hemangioma without characteristic features and wedge-shaped arterioportal shunts. |
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LR-3 | Intermediate probability of malignancy | Includes dysplastic nodules, benign lesions without characteristic features, and rounded arterioportal shunts. |
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LR-4 | Probably HCC | Includes HCC with some characteristic features.¥ |
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LR-5 | Definitely HCC† | HCC with characteristic features.** |
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LR-M | Probably or definitely malignant, not specific for HCC | Most LR-M lesions are malignant. Includes HCC without characteristic features¶¶ and other malignancies (eg, cholangiocarcinoma, combined hepatocellular carcinoma and cholangiocarcinoma, lymphoma, or metastasis). |
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LR-NC | Not categorizable | Images are insufficient for assessment. Common reasons include imaging protocol not tailored for liver lesion or images degraded from patient motion. |
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LR-TIV | Tumor in vein | Unequivocal enhancing soft tissue in vein indicating tumor, either from HCC or another malignancy. |
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