# LI-RADS (Liver Imaging Reporting and Data System)

Source: https://onco.cc/terms/li-rads/  
OnCo record `li-rads` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

LI-RADS is the radiologist's grading of a liver nodule on contrast CT or MRI in a cirrhotic liver, from LR-1 (definitely benign) to LR-5 (definitely cancer); an LR-5 lesion is treated as hepatocellular carcinoma without a biopsy, which is why liver cancer is one of the few cancers diagnosed by imaging alone.

## Summary

What is measured: the probability that a liver observation in a patient at risk (cirrhosis, chronic hepatitis B) is hepatocellular carcinoma. How: multiphase contrast CT or MRI read for the major features (size, non-rim arterial phase hyperenhancement, non-peripheral washout, an enhancing capsule and threshold growth) and ancillary features, giving LR-1 to LR-5, plus LR-M for a malignancy that may not be HCC (cholangiocarcinoma, for example) and LR-TIV for tumour in a vein; LR-5 is about 95 percent specific but only 60 to 70 percent sensitive, so many small cancers sit in LR-3 or LR-4. Contrast ultrasound has its own CEUS LI-RADS, and treatment-response LI-RADS (LR-TR viable or non-viable) is used after ablation or embolisation. What a result changes: LR-5 establishes the diagnosis without a biopsy, feeds BCLC staging and treatment (resection, ablation, transplant listing under OPTN rules, which use LI-RADS), and starts alpha-fetoprotein and imaging follow-up; LR-3 and LR-4 lead to short-interval repeat imaging or biopsy; LR-M leads to biopsy because the treatment differs. Where it matters: early, intermediate and advanced HCC.

## Fields

- Kind: Term
- Last checked: 2026-09-17
- Also known as: LI-RADS; LI-RADS 5; LR-5; LR-4; LR-3; LR-M; LR-TIV; LR-TR; LI-RADS category; arterial phase hyperenhancement; APHE; washout appearance; non-invasive diagnosis of hepatocellular carcinoma; imaging diagnosis of liver cancer

## Sources

- American College of Radiology: LI-RADS: https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/LI-RADS

## Connected records

- terms: [Alpha-fetoprotein (AFP)](https://onco.cc/terms/afp/), [BCLC staging](https://onco.cc/terms/bclc-staging/), [Child-Pugh score](https://onco.cc/terms/child-pugh/), [Cirrhosis](https://onco.cc/terms/cirrhosis/), [RECIST](https://onco.cc/terms/recist/)
- cancers: [Advanced hepatocellular carcinoma (BCLC C)](https://onco.cc/cancers/hcc-advanced/), [Early hepatocellular carcinoma (BCLC 0 and A)](https://onco.cc/cancers/hcc-early/), [Intermediate hepatocellular carcinoma (BCLC B)](https://onco.cc/cancers/hcc-intermediate/)

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