LI-RADS Calculator

If unsure about the presence of any major feature: characterize that feature as absent.

1. Does the patient have cirrhosis, chronic hepatitis B, current or prior HCC?
Yes No

2. Does the lesion correspond with any of the following criteria?
The lesion is definitely benign.
LR-1 Definitely Benign
The lesion is probably benign.
LR-2 Probably Benign
The lesion is probably or definitely malignant but not HCC specific.
There is definite tumor in vein.
None of the above.
  • Which vessels are involved?
  • Is TIV contiguous with a parenchymal mass?
    Yes No
  • Is parenchymal mass infiltrative?
    Yes No
  • Is parenchymal mass targetoid?
    Yes No
  • Is the lesion visible on screening ultrasound?
    Yes No
  • APHE: Does the lesion enhance on arterial phase images?
    Yes No
  • SIZE: How big is the lesion in millimeters?
    >20 mm 10-19 mm <10 mm
  • MAJOR FEATURE: Does the lesion washout on later phases?
    Yes No
  • MAJOR FEATURE: Is there an enhancing capsule?
    Yes No
  • MAJOR FEATURE: Has the lesion increased in size by at least 5mm AND:
    >50% size increase in <6 months
    >100% size increase in >6 months
    Previously unseen on CT or MRI, now >10mm, in <24 months
    None of the above
  • Are there ancillary features that could be used to upgrade or downgrade the lesion? (Available for reference)
    Yes No
  • Favoring malignancy in general, not HCC in particular Favoring HCC in particular Favoring benignity
    • Ultrasound visibility as discrete nodule
    • subthreshold growth
    • restricted diffusion
    • Mild-moderate T2 hyperintensity
    • Corona enhancement
    • Fat sparing in solid mass
    • Iron sparing in solid mass
    • Transitional phase hypointensity
    • Hepatobiliary phase hypointensity
    • Nonenhancing "capsule"
    • Nodule-in-nodule
    • Mosaic architecture
    • Blood products in mass
    • Fat in mass, more than adjacent liver
  • Size Stability >2 years
  • Size reduction
  • Parallels blood pool
  • Undistorted vessels
  • Iron in mass, more than liver
  • Marked T2 hyperintensity
  • Hepatobiliary phase isointensity

LI-RADS Treatment Response Calculator

1. Is there nodular, masslike, or thick irregular tissue in or along the treated lesion>

2. Describe the enhancement pattern of the lesion:
No lesional enhancement
Treatment-specific expected enhancement pattern
Enhancement atypical for treatment-specific expected enhancement pattern and not meeting criteria for probably or definitely viable
Arterial phase hyper-enhancement
Washout appearance
Enhancement similar to pretreatment

Diagnostic Criteria

Created By: Jason Birnbaum, MD

Images and algorithm sourced from:
2017 Version of LI-RADS for CT and MR Imaging: An Update Khaled M. Elsayes, Jonathan C. Hooker, Michelle M. Agrons, Ania Z. Kielar, An Tang, Kathryn J. Fowler, Victoria Chernyak, Mustafa R. Bashir, Yuko Kono, Richard K. Do, Donald G. Mitchell, Aya Kamaya, Elizabeth M. Hecht, and Claude B. Sirlin RadioGraphics 2017 37:7, 1994-2017