2022 Volume 49 Issue 3 Pages 205-213
The Liver Imaging Reporting and Data System (LI-RADS), endorsed by the American College of Radiology (ACR), includes four algorithms: ultrasound (US) LI-RADS for hepatocellular carcinoma (HCC) screening and surveillance, contrast-enhanced US (CEUS) LI-RADS and computed tomography/magnetic resonance imaging (CT/MRI) LI-RADS for HCC diagnosis, and CT/MRI LI-RADS treatment response algorithm. Recently, LI-RADS has been adopted in clinical practice throughout the United States, and the standardization and consensus regarding the imaging diagnosis of HCC have been improved. LI-RADS achieved consistency with and integration into the American Association for the Study of Liver Diseases HCC clinical practice guidance in 2018. LI-RADS has been gaining international attention, with CT/MRI LI-RADS and CEUS LI-RADS translations now available in 11 and nine languages, respectively. Meanwhile, two US clinical guidelines, supported by the Japan Society of Ultrasonics in Medicine, the manual for abdominal US in cancer screening and health checkups and the ultrasound diagnostic criteria for hepatic tumors, have been adopted in clinical practice in Japan. Sonazoid is available clinically in Japan but not in the United States; therefore, the use of Sonazoid is not supported by CEUS LI-RADS. At present, US LI-RADS and CEUS LI-RADS are not commonly used in Japan. However, CEUS LI-RADS has the potential to become a global standard in the event of the additional inclusion of Sonazoid. We have to keep our eyes on future developments in the area of CEUS LI-RADS.
