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Review
. 2024 Nov;313(2):e232408.
doi: 10.1148/radiol.232408.

CT/MRI LI-RADS 2024 Update: Treatment Response Assessment

Anum Aslam  1 , Victoria Chernyak  1 , An Tang  1 , Frank H Miller  1 , Mustafa Bashir  1 , Richard Do  1 , Claude Sirlin  1 , Robert J Lewandowski  1 , Charles Y Kim  1 , Ania Zofia Kielar  1 , Avinash R Kambadakone  1 , Hooman Yarmohammadi  1 , Edward Kim  1 , Dawn Owen  1 , Resmi A Charalel  1 , Anuradha Shenoy-Bhangle  1 , Lauren M Burke  1 , Mishal Mendiratta-Lala  1
Affiliations
Review

CT/MRI LI-RADS 2024 Update: Treatment Response Assessment

Anum Aslam et al. Radiology. 2024 Nov.

Erratum in

  • Erratum for: CT/MRI LI-RADS 2024 Update: Treatment Response Assessment.
    Aslam A, Chernyak V, Tang A, Miller FH, Bashir M, Do R, Sirlin C, Lewandowski RJ, Kim CY, Kielar AZ, Kambadakone AR, Yarmohammadi H, Kim E, Owen D, Charalel RA, Shenoy-Bhangle A, Burke LM, Mendiratta-Lala M. Aslam A, et al. Radiology. 2025 Feb;314(2):e259002. doi: 10.1148/radiol.259002. Radiology. 2025. PMID: 39998379 Free PMC article. No abstract available.

Abstract

With the rising incidence of hepatocellular carcinoma, there has been increasing use of local-regional therapy (LRT) to downstage or bridge to transplant, for definitive treatment, and for palliation. The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Assessment (TRA) algorithm provides guidance for step-by-step tumor assessment after LRT and standardized reporting. Current evidence suggests that the algorithm performs well in the assessment of tumor response to arterial embolic and loco-ablative therapies and fair when assessing response to radiation-based therapies, with limited data to validate the latter. Both evidence-based and expert-based refinements of the algorithm are needed to improve its diagnostic accuracy after varying types of LRT. This review provides an overview of the challenges and limitations of the LI-RADS TRA algorithm version 2017 and discusses the refinements introduced in the updated 2024 LI-RADS algorithm for CT/MRI.

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Conflict of interest statement

Disclosures of conflicts of interest: A.A. No relevant relationships. V.C. Consulting fees from Bayer and Gilead. F.H.M. Consulting fees from Bayer; medical advisory board member for Guerbet. M.B. Grants from Siemens Healthineers, Madrigal Pharmaceuticals, Carmot Therapeutics, Corcept Therapeutics, and NGM Bio; editorial board member for the Journal of Magnetic Resonance Imaging. R.D. Grant to institution from the National Institutes of Health/National Cancer Institute; royalties from Elsevier; consulting fees from Ascelia Pharma. C.S. Grants to institution from the American College of Radiology, Bayer, GE HealthCare, Pfizer, Gilead, Philips, and Siemens; laboratory service agreements with OrsoBio, Enanta, Gilead, ICON, Intercept, NuSirt, Shire, Synageva, and Takeda; royalties from Medscape and Wolters Kluwer; consulting fees from Altimmune, Ascelia Pharma, Blade, Boehringer, Epigenomics, and Guerbet; consulting fees to institution from AMRA, BMS, Exact Sciences, IBM-Watson, and Pfizer; payment for educational symposia; travel support from Fundación Santa Fe, CADI, Stanford, Jornada Paulista de Radiologia, and Ascelia Pharma; participation on a data safety monitoring board or advisory board for Quantix Bio (unpaid); former chief medical officer for Livivos and former member of the Society of Abdominal Radiology board of directors; stock and stock options in Livivos; equipment loan to institution from GE HealthCare; member of the LI-RADS Steering Committee and LI-RADS working groups (unpaid). R.J.L. Grant to institution from the National Institutes of Health; consulting fees from Boston Scientific, BD, Varian, and AstraZeneca; payment for lectures from Boston Scientific; president elect of the Society of Interventional Radiology (SIR). C.Y.K. Consulting fees from Boston Scientific, ACI/Humacyte, and Baylis Medical. A.Z.K. Travel support from the Canadian Association of Radiologists; president of the Canadian Association of Radiologists. A.R.K. Grants from GE HealthCare, Pancreatic Cancer Action Network, Philips, and Bayer; royalties from Elsevier; consulting fees from Bayer; travel support from International Diagnostic Course Davos. H.Y. Research grants from Guerbet and Thompson Family Foundation; advisory board member for AstraZeneca and Guerbet; patent planned, issued, or pending with the Yarmohammadi Foundation. E.K. Advisory board member for AstraZeneca, Roche/Genentech, Boston Scientific, Eisai, and Varian Interventional Solutions. D.O. Research funding from AstraZeneca and Varian; honorarium from UpToDate. R.A.C. Grants from GERRAF (via the Association of Academic Radiology [AUR], funded by GE HealthCare), SIR Foundation, Instylla, and Food and Drug Administration; consulting fees from TriSalus Life Sciences and Embolx; payment for lectures from the Cleveland Clinic, Sirtex Medical, American College of Surgery, and TriSalus Life Sciences; support for travel from Digestive Disease Interventions, SIR, TriSalus Life Sciences, and AUR; participation on a data safety monitoring board or advisory board for Embolx; chair of the SIR Quality Data Analytics Committee; stock or stock options in Embolx. A.S.B. No relevant relationships. L.M.B. No relevant relationships. M.M.L. No relevant relationships.

References

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